Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography
Purpose: Among extraosseous abnormalities of the vertebral artery (VA) at the craniovertebral junction (CVJ), available evidence regarding "posterolateral protrusion," the VA running distant from the groove over the superior surface of the posterior arch of the atlas, is limited. The purpo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2014;volume=5;issue=4;spage=151;epage=156;aulast=Ohya |
| _version_ | 1828353802340663296 |
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| author | Junichi Ohya Kota Miyoshi Hiroyuki Oka KO Matsudaira Masayoshi Fukushima Kosei Nagata |
| author_facet | Junichi Ohya Kota Miyoshi Hiroyuki Oka KO Matsudaira Masayoshi Fukushima Kosei Nagata |
| author_sort | Junichi Ohya |
| collection | DOAJ |
| description | Purpose: Among extraosseous abnormalities of the vertebral artery (VA) at the craniovertebral junction (CVJ), available evidence regarding "posterolateral protrusion," the VA running distant from the groove over the superior surface of the posterior arch of the atlas, is limited. The purpose of this study was to determine the optimal measurement to indicate posterolateral protrusion of the VA. Materials and Methods: Computed tomography angiography (CTA) images of 40 consecutive patients with cervical disease were reviewed. Ultimately, 66 arteries were included in this study. Five parameters predicted to indicate posterolateral protrusion of the VA were defined (A-E) and measured by two surgeons twice over a 2-week interval. Intraclass correlation coefficients (ICC) were used to examine intra-observer reproducibility and inter-observer reliability. Receiver operating characteristic (ROC) curve analysis was performed to determine the most optimal parameter to predict posterolateral protrusion of the VA. Results: Excellent inter-observer reliability and intra-observer reproducibility were obtained for all parameters (ICC = 0.87-0.99). Among them, parameter A, defined as the maximal length from the outer surface of the VA to the outer surface of the posterior arch of the atlas, was most accurately described posterolateral protrusion of the VA. The optimal cut-off value of parameter A obtained with ROC curves was 8.3 mm (sensitivity 97.5%, specificity 100%). Conclusions: The measurement in this study can quantitatively evaluate the posterolateral protrusion of the VA. Before posterior surgery at the CVJ, pre-operative CTA can help surgeons detect anomalous VA and reduce the risk of intra-operative VA injury. |
| first_indexed | 2024-04-14T02:14:39Z |
| format | Article |
| id | doaj.art-9f81bbe27b034405901c4e2d96015bd6 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-04-14T02:14:39Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-9f81bbe27b034405901c4e2d96015bd62022-12-22T02:18:17ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372014-01-015415115610.4103/0974-8237.147077Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiographyJunichi OhyaKota MiyoshiHiroyuki OkaKO MatsudairaMasayoshi FukushimaKosei NagataPurpose: Among extraosseous abnormalities of the vertebral artery (VA) at the craniovertebral junction (CVJ), available evidence regarding "posterolateral protrusion," the VA running distant from the groove over the superior surface of the posterior arch of the atlas, is limited. The purpose of this study was to determine the optimal measurement to indicate posterolateral protrusion of the VA. Materials and Methods: Computed tomography angiography (CTA) images of 40 consecutive patients with cervical disease were reviewed. Ultimately, 66 arteries were included in this study. Five parameters predicted to indicate posterolateral protrusion of the VA were defined (A-E) and measured by two surgeons twice over a 2-week interval. Intraclass correlation coefficients (ICC) were used to examine intra-observer reproducibility and inter-observer reliability. Receiver operating characteristic (ROC) curve analysis was performed to determine the most optimal parameter to predict posterolateral protrusion of the VA. Results: Excellent inter-observer reliability and intra-observer reproducibility were obtained for all parameters (ICC = 0.87-0.99). Among them, parameter A, defined as the maximal length from the outer surface of the VA to the outer surface of the posterior arch of the atlas, was most accurately described posterolateral protrusion of the VA. The optimal cut-off value of parameter A obtained with ROC curves was 8.3 mm (sensitivity 97.5%, specificity 100%). Conclusions: The measurement in this study can quantitatively evaluate the posterolateral protrusion of the VA. Before posterior surgery at the CVJ, pre-operative CTA can help surgeons detect anomalous VA and reduce the risk of intra-operative VA injury.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2014;volume=5;issue=4;spage=151;epage=156;aulast=OhyaAtlascomputed tomography angiographyposterolateral protrusionvertebral artery |
| spellingShingle | Junichi Ohya Kota Miyoshi Hiroyuki Oka KO Matsudaira Masayoshi Fukushima Kosei Nagata Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography Journal of Craniovertebral Junction and Spine Atlas computed tomography angiography posterolateral protrusion vertebral artery |
| title | Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| title_full | Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| title_fullStr | Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| title_full_unstemmed | Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| title_short | Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| title_sort | optimal measurement for posterolateral protrusion of the vertebral artery at the craniovertebral junction using computed tomography angiography |
| topic | Atlas computed tomography angiography posterolateral protrusion vertebral artery |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2014;volume=5;issue=4;spage=151;epage=156;aulast=Ohya |
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