Arnold-Chiari malformation MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

MRI

• MRI is the imaging modality of choice to evaluate for a Chiari I malformation. MRI findings:
  • Cerebellar tonsillar herniation
  • Wedge shaped tonsils
  • Syringohydromyelia
  • Small posterior fossa
  • Obstructive hydrocephalus
  • Brainstem anomalies
• Tonsillar displacement is measured from the basion-opisthion line on a sigittal image.
• Herniation is usually at least 5mm, though patients with 3-5mm herniation may also have the malformation.
• MRI CSF flow studies may prove to be helpful and are currently under investigation.