Chiari Malformation: Tests and Diagnosis

What tests are used to diagnose Chiari Malformation Type 1 (CMI)?

Magnetic Resonance Imaging (MRI) – MRI is a magnetic-based test that does not involve radiation. It has allowed many children with CMI to be diagnosed before significant symptoms develop and is the best test to show the anatomy of the brain and spinal cord tissue.

Tests for a child thought to have CMI should include MRI imaging of the brain to rule out a Chiari malformation caused by a mass lesion or hydrocephalus. An MRI of the entire spine should be done to test for the possibility of a fluid collection within the spinal cord, abnormal curvature if the spine (scoliosis) or other less common abnormalities such as a tethered spinal cord.

Computerized Tomography (CT) – A CT scan is an x-ray based test that shows the bone of the skull and spine in better detail than any other imaging test. It is sometimes, but not always, part of the evaluation of a patient with CMI.

X-ray – An upright spine x-ray is also used to look for abnormal curvature of the spine (scoliosis).  X-rays with the patient flexing and extending the neck may be needed to evaluate movement between the bones of the neck or skull and neck.

Why choose Children's Hospital Colorado for testing?

An MRI is the best test for children with suspected CMI, and it has the advantage of being a radiation-free test. However, MRI machines are noisy and the test can last about an hour. Because of this, many children require sedation in order to remain still during the study.

Children's Colorado has anesthesia and radiology specialists who take care of children all day, every day. They have considerable experience handling the big and small details that make the imaging experience as smooth as possible for your child and family.

What should you expect from an MRI?

The longest test used to diagnose Chiari malformation is an MRI of the entire spine. Because this test can last for about an hour, younger children may need anesthesia to stay calm and still. For older children, we provide ear buds and glasses for the patient to watch movies during the study.

How do doctors at Children's Colorado diagnose Chiari malformation?

The MRI scan shows whether the back or bottom of the brain extends into the spinal canal. It can also show if there is a fluid collection in the spinal cord (syrinx) or abnormal curvature of the spine (scoliosis). We combine this information with an evaluation of your child's history and physical examination in order to determine if there is symptomatic CMI, which may require surgery.