{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:46:24Z","timestamp":1789670784488,"version":"4.0.1"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The distance to the ventral dura, perpendicular to the basion to C2 line (pB-C2), is commonly employed as a measure describing the anatomy of the craniovertebral junction. However, both the reliability among observers and the clinical utility of this measurement in the context of Chiari malformation Type I (CM-I) have been incompletely determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data were reviewed from the first 600 patients enrolled in the Park-Reeves Syringomyelia Research Consortium with CM-I and syringomyelia. Thirty-one cases were identified in which both CT and MRI studies were available for review. Three pediatric neurosurgeons independently determined pB-C2 values using common imaging sequences: MRI (T1-weighted and T2-weighted with and without the inclusion of retro-odontoid soft tissue) and CT. Values were compared and intraclass correlations were calculated among imaging modalities and observers.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Intraclass correlation of pB-C2 demonstrated strong agreement between observers (intraclass correlation coefficient [ICC] range 0.72\u20130.76). Measurement using T2-weighted MRI with the inclusion of retro-odontoid soft tissue showed no significant difference with measurement using T1-weighted MRI. Measurements using CT or T2-weighted MRI without retro-odontoid soft tissue differed by 1.6 mm (4.69 and 3.09 mm, respectively, p &lt; 0.05) and were significantly shorter than those using the other 2 sequences.<\/jats:p><jats:p>Conclusions pB-C2 can be measured reliably by multiple observers in the context of pediatric CM-I with syringomeyelia. Measurement using T2-weighted MRI excluding retro-odontoid soft tissue closely approximates the value obtained using CT, which may allow for the less frequent use of CT in this patient population. Measurement using T2-weighted MRI including retro-odontoid soft tissue or using T1-weighted MRI yields a more complete assessment of the extent of ventral brainstem compression, but its association with clinical outcomes requires further study.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.3.peds16604","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T13:57:21Z","timestamp":1495202241000},"page":"170-175","source":"Crossref","is-referenced-by-count":9,"title":["Analysis and interrater reliability of pB-C2 using MRI and CT: data from the Park-Reeves Syringomyelia Research Consortium on behalf of the Pediatric Craniocervical Society"],"prefix":"10.3171","volume":"20","author":[{"given":"Todd C.","family":"Hankinson","sequence":"first","affiliation":[{"name":"Pediatric Neurosurgery, Children\u2019s Hospital Colorado, University of Colorado Anschutz Medical Campus, and"},{"name":"Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald F.","family":"Tuite","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Neuroscience Institute, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmara I.","family":"Moscoso","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University, Morgan Stanley Children\u2019s Hospital of NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie C.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"University of Iowa College of Public Health, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Limbrick","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Sung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C. 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