Magnetic resonance imaging of pseudotumors of the craniovertebral junctionin long-term hemodialysis patients

Background/Aims: Pseudotumors of the craniovertebral junction (PTCVJ) are o bserved in long-term hemodialysis (HD) patients. There are neither criteria for diagnosis nor guidelines for screening. We attempted to determine magn etic resonance imaging (MRI) findings that could be used to detect PTCVJ, t o determine the prevalence of PTCVJ, and to evaluate whether destructive sp ondyloarthropathy (DSA) might be a yardstick for selection of patients for MRI examination for PTCVJ. Methods: MRI were examined in 19 DSA patients (8 males, 11 females, age 61.4 +/- 7.3 years, HD duration 17.0 +/- 4.4 years) and in 20 sex-, age-, and HD-duration-matched non-DSA patients (9 males, 1 1 females, age 57.5 +/- 6.6 years, HD duration 17.7 +/- 4.9 years). We eval uated MRI characteristics of PTCVJ according those which occur due to rheum atoid arthritis. Results: PTCVJ were characterized as follows: disappearanc e of fat pads in the upper region (supradental PTCVJ), intensity change of the 'predental triangle' in the anterior region (predental PTCVJ), and thic kening of cruciform ligaments (retrodental PTCVJ). The prevalence of PTCVJ among patients undergoing HD more than 10 years was high (26 out of 39; 66. 7%). The prevalence of PTCVJ was not different between DSA and non-DSA grou ps. Conclusion: We verified that the above MRI findings might be helpful in the detection of PTCVJ. These findings were observed frequently and indepe ndently also in patients with DSA. Copyright (C) 1999 S. Karger AG, Basel.