{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:29:07Z","timestamp":1780054147626,"version":"3.54.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"IVC Evidensia","award":["9077_7504-02_KS_Evaluation of CT based"],"award-info":[{"award-number":["9077_7504-02_KS_Evaluation of CT based"]}]},{"name":"IVC Evidensia","award":["9077_Apr22_PM_CM-and-SM"],"award-info":[{"award-number":["9077_Apr22_PM_CM-and-SM"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Studies in Pomeranians as well as other breeds have looked at clinical signs or external features as predictors of Chiari-like malformation (CM) and syringomyelia (SM). The aim of this study is to describe and analyze morphometric factors of the skull of Pomeranians with and without CM\/SM by means of CT as well as manual external measurements. Ninety-two Pomeranians &gt;12 months of age were included that underwent both CT and MRI studies of the head and cervicothoracic vertebral column. Two observers independently reviewed the CT imaging studies and performed quantitative measurements. External measurements were taken from the head of dogs when under general anesthesia using a tape measure and a caliper. Externally measured mandible length was associated with the probability of having SM (p = 0.043). Mandible length was moderately correlated with weight (Pearson correlation coefficient = 0.585, p &lt; 0.001). A cutoff for mandible length of 58 mm yielded a sensitivity of 96% (95% confidence interval 89\u2013100%), meaning dogs in this study population with a mandible length shorter than 58 mm were highly likely to have SM. The measurement of the length of the mandible could help to determine the probability of a Pomeranian having SM, especially when combined with the presence or absence of owner reported clinicals signs as shown in previous studies.<\/jats:p>","DOI":"10.1371\/journal.pone.0313203","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:36:52Z","timestamp":1732559812000},"page":"e0313203","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["CT-based and manual external skull measurements for Chiari-like malformation and syringomyelia in Pomeranians"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7552-216X","authenticated-orcid":true,"given":"Koen M.","family":"Santifort","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Bellekom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Carrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-6673","authenticated-orcid":true,"given":"Paul J. J.","family":"Mandigers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"pone.0313203.ref001","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.tvjl.2013.07.014","article-title":"An update on the pathogenesis of syringomyelia secondary to Chiari-like malformations in dogs","volume":"198","author":"CJ Driver","year":"2013","journal-title":"Vet J"},{"key":"pone.0313203.ref002","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3389\/fvets.2018.00171","article-title":"Morphogenesis of Canine Chiari Malformation and Secondary Syringomyelia: Disorders of Cerebrospinal Fluid Circulation","volume":"5","author":"SP Knowler","year":"2018","journal-title":"Front Vet Sci"},{"key":"pone.0313203.ref003","first-page":"139","article-title":"The need for head space: brachycephaly and cerebrospinal fluid disorders","volume":"11","author":"C Rusbridge","year":"2021","journal-title":"Life (Basel)"},{"key":"pone.0313203.ref004","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3389\/fvets.2018.00280","article-title":"Clinical application of diagnostic imaging of chiari-like malformation and syringomyelia","volume":"5","author":"C Rusbridge","year":"2018","journal-title":"Front Vet Sci"},{"issue":"5","key":"pone.0313203.ref005","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1111\/jvim.12421","article-title":"Chiari-like malformation and syringomyelia in American Brussels Griffon dogs","volume":"28","author":"AC Freeman","year":"2014","journal-title":"J Vet Intern Med"},{"issue":"1","key":"pone.0313203.ref006","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2460\/ajvr.73.1.105","article-title":"Morphometric features of the craniocervical junction region in dogs with suspected Chiari-like malformation determined by combined use of magnetic resonance imaging and computed tomography","volume":"73","author":"DJ Marino","year":"2012","journal-title":"Am J Vet Res"},{"key":"pone.0313203.ref007","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/jvim.15632","article-title":"Facial changes related to brachycephaly in Cavalier King Charles Spaniels with Chiari\u2010like malformation associated pain and secondary syringomyelia","volume":"34","author":"SP Knowler","year":"2020","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2052-6687-1-9","article-title":"Syringomyelia: determining risk and protective factors in the conformation of the Cavalier King Charles Spaniel dog","volume":"1","author":"TJ Mitchell","year":"2014","journal-title":"Canine Genet Epidemiol"},{"key":"pone.0313203.ref009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12917-017-1258-2","article-title":"MRI characteristics for \u201cphantom\u201d scratching in canine syringomyelia","volume":"13","author":"ZR Nalborczyk","year":"2017","journal-title":"BMC Vet Res"},{"key":"pone.0313203.ref010","doi-asserted-by":"crossref","DOI":"10.3389\/fnana.2023.1175953","article-title":"Reduced cingulate gyrus volume in Cavalier King Charles Spaniels with syringomyelia and neuropathic pain revealed by voxel-based morphometry: a pilot study","volume":"17","author":"B Nitzsche","year":"2023","journal-title":"Front Neuroanat"},{"key":"pone.0313203.ref011","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/jvim.15437","article-title":"Morphometric analysis of spinal cord termination in Cavalier King Charles Spaniels","volume":"33","author":"CR Sparks","year":"2019","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref012","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1111\/jvim.15621","article-title":"Using machine learning to understand neuromorphological change and image\u2010based biomarker identification in Cavalier King Charles Spaniels with Chiari\u2010like malformation\u2010associated pain and syringomyelia","volume":"33","author":"M Spiteri","year":"2019","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref013","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1111\/jvim.16123","article-title":"Persistent fontanelles in Chihuahuas. Part II: Association with craniocervical junction abnormalities, syringomyelia, and ventricular volume","volume":"35","author":"AM Kiviranta","year":"2021","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref014","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1111\/jvim.14826","article-title":"Syringomyelia and craniocervical junction abnormalities in Chihuahuas","volume":"31","author":"AM Kiviranta","year":"2017","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref015","article-title":"Craniometric Analysis of the Hindbrain and Craniocervical Junction of Chihuahua, Affenpinscher and Cavalier King Charles Spaniel Dogs With and Without Syringomyelia Secondary to Chiari-Like Malformation","volume":"12","author":"SP Knowler","year":"2017","journal-title":"PLoS One"},{"key":"pone.0313203.ref016","article-title":"Use of Morphometric Mapping to Characterise Symptomatic Chiari-Like Malformation, Secondary Syringomyelia and Associated Brachycephaly in the Cavalier King Charles Spaniel","volume":"12","author":"SP Knowler","year":"2017","journal-title":"PLoS One"},{"key":"pone.0313203.ref017","doi-asserted-by":"crossref","first-page":"1326621","DOI":"10.3389\/fvets.2024.1326621","article-title":"The effect of MRI-based screening and selection on the prevalence of syringomyelia in the Dutch and Danish Cavalier King Charles Spaniels","volume":"11","author":"C Limpens","year":"2024","journal-title":"Front Vet Sci"},{"key":"pone.0313203.ref018","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/jvim.12475","article-title":"Prevalence and heritability of symptomatic syringomyelia in Cavalier King Charles Spaniels and long\u2010term outcome in symptomatic and asymptomatic littermates","volume":"29","author":"MS Th\u00f8fner","year":"2015","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref019","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1111\/jvim.15552","article-title":"Behavioral and clinical signs of Chiari\u2010like malformation\u2010associated pain and syringomyelia in Cavalier King Charles Spaniels","volume":"33","author":"C Rusbridge","year":"2019","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref020","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13028-024-00725-1","article-title":"Clinical predictors of syringomyelia in Cavalier King Charles Spaniels with chiari-like malformation based on owners\u2019 observations","volume":"66","author":"TR Pedersen","year":"2024","journal-title":"Acta Vet Scand"},{"key":"pone.0313203.ref021","doi-asserted-by":"crossref","first-page":"1320942","DOI":"10.3389\/fvets.2023.1320942","article-title":"Phenotypic characterization of Pomeranians with or without Chiari-like malformation and syringomyelia","volume":"10","author":"KM Santifort","year":"2023","journal-title":"Front Vet Sci"},{"key":"pone.0313203.ref022","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/jvim.14856","article-title":"Questionnaire\u2010based analysis of owner\u2010reported scratching and pain signs in Cavalier King Charles Spaniels screened for Chiari\u2010like malformation and syringomyelia","volume":"32","author":"CR Sparks","year":"2018","journal-title":"J Vet Intern Med"},{"key":"pone.0313203.ref023","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.3390\/ani14131854","article-title":"Craniocervical Morphometry in Pomeranians\u2014Part I: In-tra-Observer, Interobserver, and Intermodality (CT vs. MRI) Agreement","volume":"14","author":"K Santifort","year":"2024","journal-title":"Animals"},{"key":"pone.0313203.ref024","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.3390\/ani14131859","article-title":"Craniocervical Morphometry in Pomeranians\u2014Part II: Associations with Chiari-like Malformation and Syringomyelia","volume":"14","author":"K Santifort","year":"2024","journal-title":"Animals"},{"key":"pone.0313203.ref025","doi-asserted-by":"crossref","first-page":"3762651","DOI":"10.1155\/2017\/3762651","article-title":"Defining an Optimal Cut-Point Value in ROC Analysis: An Alternative Approach","volume":"2017","author":"I. Unal","year":"2017","journal-title":"Comput Math Methods Med"},{"key":"pone.0313203.ref026","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00381-004-1115-z","article-title":"Chiari malformation in craniosynostosis","volume":"21","author":"G Cinalli","year":"2005","journal-title":"Childs Nerv Syst"},{"issue":"2","key":"pone.0313203.ref027","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/1817-1745.43652","article-title":"Chiari III malformation with hypertelorism and microcephaly in a neonate: case report and a review of the literature","volume":"3","author":"K Garg","year":"2008","journal-title":"J Pediatr Neurosci"},{"issue":"4","key":"pone.0313203.ref028","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3171\/2009.10.PEDS09155","article-title":"Craniofrontonasal dysplasia associated with Chiari malformation: Report of 3 cases","volume":"5","author":"A Mahore","year":"2010","journal-title":"J Neurosurg Pediatr"},{"key":"pone.0313203.ref029","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1007\/s00381-021-05134-7","article-title":"Craniofrontonasal dysplasia: hypertelorism correction in late presenting patients","volume":"37","author":"CE Raposo-Amaral","year":"2021","journal-title":"Childs Nerv Syst"},{"key":"pone.0313203.ref030","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s00381-019-04319-5","article-title":"Chiari I malformation in defined genetic syndromes in children: are there common pathways?","volume":"35","author":"V Saletti","year":"2019","journal-title":"Childs Nerv Syst"},{"issue":"3","key":"pone.0313203.ref031","doi-asserted-by":"crossref","DOI":"10.3171\/2011.6.FOCUS11107","article-title":"Chiari malformation associated with craniosynostosis","volume":"31","author":"J Strahle","year":"2011","journal-title":"Neurosurg Focus"},{"key":"pone.0313203.ref032","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1111\/j.1748-5827.2008.00578.x","article-title":"Chiari-like malformation and syringomyelia in normal cavalier King Charles spaniels: a multiple diagnostic imaging approach","volume":"49","author":"J Couturier","year":"2008","journal-title":"J Small Anim Pract"},{"key":"pone.0313203.ref033","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1136\/vr.153.9.260","article-title":"Neurological signs and results of magnetic resonance imaging in 40 cavalier King Charles spaniels with Chiari type 1-like malformations","volume":"153","author":"D Lu","year":"2003","journal-title":"Vet Rec"},{"key":"pone.0313203.ref034","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1292\/jvms.22-0134","article-title":"Ventriculomegaly in Cavalier King Charles Spaniels with Chiari-like malformation: relationship with clinical and imaging findings","volume":"84","author":"F Tirrito","year":"2022","journal-title":"J Vet Med Sci"},{"issue":"9","key":"pone.0313203.ref035","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0184893","article-title":"Twelve years of chiari-like malformation and syringomyelia scanning in Cavalier King Charles Spaniels in the Netherlands: Towards a more precise phenotype","volume":"12","author":"K Wijnrocx","year":"2017","journal-title":"PLoS One"},{"key":"pone.0313203.ref036","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1136\/vr.105135","article-title":"Pilot study of head conformation changes over time in the Cavalier King Charles Spaniel breed","volume":"184","author":"SP Knowler","year":"2019","journal-title":"Vet Rec"},{"issue":"S1","key":"pone.0313203.ref037","doi-asserted-by":"crossref","first-page":"81","DOI":"10.7120\/096272812X13345905673809","article-title":"Do dog owners perceive the clinical signs related to conformational inherited disorders as \u2018normal\u2019 for the breed? A potential constraint to improving canine welfare","volume":"21","author":"RMA Packer","year":"2012","journal-title":"Anim Welf"},{"issue":"10","key":"pone.0313203.ref038","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0137496","article-title":"Impact of facial conformation on canine health: brachycephalic obstructive airway syndrome","volume":"10","author":"RM Packer","year":"2015","journal-title":"PLoS One"},{"issue":"8","key":"pone.0313203.ref039","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/j.1748-5827.2009.00744.x","article-title":"Chiari\u2010like malformation in the Griffon Bruxellois","volume":"50","author":"C Rusbridge","year":"2009","journal-title":"J Small Anim Pract"},{"issue":"1","key":"pone.0313203.ref040","article-title":"Exceptional changes in skeletal anatomy under domestication: the case of brachycephaly","volume":"3","author":"M Geiger","year":"2021","journal-title":"Integr Organ Biol"},{"key":"pone.0313203.ref041","article-title":"Comparison of growth trajectories among ancient and modern breeds rejects a paedomorphic pattern of change associated with dog domestication","volume":"90","author":"M Geiger","year":"2015","journal-title":"Skeletal Growth and Life History Evolution in Wild and Domesticated Mammals"},{"key":"pone.0313203.ref042","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jcpa.2020.02.008","article-title":"Canine Brachycephaly: Anatomy, Pathology, Genetics and Welfare","volume":"176","author":"KJ Ekenstedt","year":"2020","journal-title":"J Comp Pathol"},{"issue":"2","key":"pone.0313203.ref043","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1002\/ar.24184","article-title":"The impact of selection for facial reduction in dogs: geometric morphometric analysis of canine cranial shape","volume":"303","author":"MC Selba","year":"2020","journal-title":"Anat Rec"},{"key":"pone.0313203.ref044","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/j.1740-8261.2011.01825.x","article-title":"Cephalometric measurements and determination of general skull type of Cavalier King Charles Spaniels","volume":"52","author":"MJ Schmidt","year":"2011","journal-title":"Vet Radiol Ultrasound"},{"key":"pone.0313203.ref045","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1002\/ar.23313","article-title":"Cranial suture closure in domestic dog breeds and its relationships to skull morphology","volume":"299","author":"M Geiger","year":"2016","journal-title":"Anat Rec"},{"issue":"5","key":"pone.0313203.ref046","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/vru.12072","article-title":"Comparison of closure times for cranial base synchondroses in mesaticephalic, brachycephalic, and Cavalier King Charles Spaniel dogs","volume":"54","author":"MJ Schmidt","year":"2013","journal-title":"Vet Radiol Ultrasound"},{"issue":"3","key":"pone.0313203.ref047","doi-asserted-by":"crossref","first-page":"218","DOI":"10.2307\/2405381","article-title":"Histological changes correlated with evolutionary changes of body size","volume":"2","author":"B. Rensch","year":"1948","journal-title":"Evolution"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:37:13Z","timestamp":1732559833000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313203"}},"subtitle":[],"editor":[{"given":"Karolina","family":"Go\u017adziewska-Har\u0142ajczuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":47,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313203","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,25]]}}}