Annals of Biomedical Engineering

, Volume 47, Issue 11, pp 2284–2295 | Cite as

Three-Dimensional CT Morphometric Image Analysis of the Clivus and Sphenoid Sinus in Chiari Malformation Type I

  • Blaise Simplice Talla NwotchouangEmail author
  • Maggie S. Eppelheimer
  • Paul Bishop
  • Dipankar Biswas
  • Janna M. Andronowski
  • Jayapalli R. Bapuraj
  • David Frim
  • Rick Labuda
  • Rouzbeh Amini
  • Francis Loth


This study evaluated three-dimensional (3D) volumetric image reconstructions to identify morphological differences of the clivus and sphenoid sinus on computed tomography (CT) scans of Chiari malformation type I (CMI) and control subjects. Axial CT images of adult females for 30 CMI subjects and 30 age and body mass index (BMI) matched controls were used for this retrospective study. 3D volumetric reconstructions were created from the bone windows of axial data following image registration for position and orientation correction of the head. The volume, surface area, linear dimensions and spatial position in the x, y, and z-axes were computed separately for the clivus and the sphenoid sinus for each subject. Eleven parameters were found to be significantly different between CMI subjects compared to controls. Most notably, clivus volume was reduced by 31% on average in CMI subjects. In contrast, we found that the sphenoid sinus volume was 38% greater on average in CMI subjects. Moreover, clivus length, height, width, and thickness were 3.7, 2.8, 3.0 and 9.4 mm reduced, respectively, in CMI subjects. This is the first study to demonstrate cephalometric differences in the 3D morphology of the clivus and sphenoid sinus between CMI subjects and controls.


Clivus Chiari 3D image registration Osseous Tonsillar position Posterior cranial fossa Sella turcica 



The authors would like to thank Conquer Chiari for providing funding for this research work. The authors would also like to acknowledge the contribution of Dr. Philip Allen for his support of interpreting the statistical results and Jiyoon Kim for her support in the segmentation process. Finally, we want to thank the individuals who donated their CT scans for this research.

Conflict of interest

All authors declared that they have no conflict of interest

Ethical Approval

This study was submitted and approved by the local Institutional Review Boards of The University of Akron and the Cleveland Clinic Foundation.


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Copyright information

© Biomedical Engineering Society 2019

Authors and Affiliations

  • Blaise Simplice Talla Nwotchouang
    • 1
    Email author
  • Maggie S. Eppelheimer
    • 1
  • Paul Bishop
    • 1
    • 2
  • Dipankar Biswas
    • 3
  • Janna M. Andronowski
    • 4
  • Jayapalli R. Bapuraj
    • 5
  • David Frim
    • 6
  • Rick Labuda
    • 7
  • Rouzbeh Amini
    • 1
  • Francis Loth
    • 1
    • 3
  1. 1.Department of Biomedical EngineeringUniversity of AkronAkronUSA
  2. 2.Department of Vascular SurgeryCleveland ClinicClevelandUSA
  3. 3.Department of Mechanical EngineeringUniversity of AkronAkronUSA
  4. 4.Department of BiologyUniversity of AkronAkronUSA
  5. 5.Department of RadiologyUniversity of Michigan Health SystemAnn ArborUSA
  6. 6.Department of NeurosurgeryUniversity of ChicagoChicagoUSA
  7. 7.Conquer ChiariWexfordUSA

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