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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 purpose of this...

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Autores principales: Ohya, Junichi, Miyoshi, Kota, Oka, Hiroyuki, Matsudaira, KO, Fukushima, Masayoshi, Nagata, Kosei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279277/
https://www.ncbi.nlm.nih.gov/pubmed/25558145
http://dx.doi.org/10.4103/0974-8237.147077
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author Ohya, Junichi
Miyoshi, Kota
Oka, Hiroyuki
Matsudaira, KO
Fukushima, Masayoshi
Nagata, Kosei
author_facet Ohya, Junichi
Miyoshi, Kota
Oka, Hiroyuki
Matsudaira, KO
Fukushima, Masayoshi
Nagata, Kosei
author_sort Ohya, Junichi
collection PubMed
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.
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spelling pubmed-42792772015-01-02 Optimal measurement for “posterolateral protrusion” of the vertebral artery at the craniovertebral junction using computed tomography angiography Ohya, Junichi Miyoshi, Kota Oka, Hiroyuki Matsudaira, KO Fukushima, Masayoshi Nagata, Kosei J Craniovertebr Junction Spine Original Article 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. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4279277/ /pubmed/25558145 http://dx.doi.org/10.4103/0974-8237.147077 Text en Copyright: © Journal of Craniovertebral Junction and Spine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ohya, Junichi
Miyoshi, Kota
Oka, Hiroyuki
Matsudaira, KO
Fukushima, Masayoshi
Nagata, Kosei
Optimal measurement for “posterolateral protrusion” of the vertebral artery at the craniovertebral junction using computed tomography angiography
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279277/
https://www.ncbi.nlm.nih.gov/pubmed/25558145
http://dx.doi.org/10.4103/0974-8237.147077
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