{
  "abstract": "Background/Objectives: Posterior fossa decompression (PFD) with superficial durotomy is used in Chiari I malformation to limit the CSF-related complications of complete durotomy and duraplasty, but quantitative volumetric evidence has relied on linear measurements, modest cohorts, and heterogeneous methods. We applied a fully automated deep-learning segmentation pipeline to characterize multi-structure volumetric change after PFD with superficial durotomy. Methods: Thirty-three patients (24 females and nine males; mean age, 39.2 ± 13.5 years; two pediatric) with symptomatic Chiari I malformation underwent PFD with superficial durotomy. Pre-operative and 6-month post-operative 3D T1-weighted 1.5T MRIs were segmented using nnU-Net, CERES, TotalSegmentator, and nnDetection. Posterior fossa volume (PFV), supratentorial volume, PFV/STV ratio, cerebellar volume, brainstem volume, fourth ventricle volume, basal cisterns’ CSF volume, and tonsillar descent were computed and compared pre/post using paired t-tests or Wilcoxon tests, Cohen’s d with bootstrapped 95% confidence intervals, and Benjamini–Hochberg correction. The pipeline was developed and validated exclusively on 1.5T Siemens Aera data and is not presented as ready for out-of-box use on other scanner platforms without re-validation. Results: PFV increased from 166.0 ± 12.9 to 172.5 ± 13.1 mL (Δ + 6.5 mL; p < 0.001; d = 1.72). Tonsillar descent decreased from 8.0 ± 2.8 to 4.9 ± 2.8 mm (Δ −3.1 mm; p < 0.001; d = −2.74). Basal cisterns’ CSF volume increased from 8.8 ± 1.5 to 11.0 ± 2.4 mL (Δ + 2.2 mL; p < 0.001; d = 1.16). Fourth ventricle volume increased (p < 0.001; d = 1.58). Cerebellar volume increased modestly (p < 0.001, q < 0.001; d = 0.86), while brainstem volume was unchanged (p = 0.22, q = 0.22; d = −0.11). Seven of eight primary outcomes remained significant after false-discovery-rate correction. Twenty-nine of 33 patients (87.9%) achieved tonsillar ascent of at least 2 mm. Conclusions: Automated volumetric analysis demonstrated significant posterior fossa expansion, basal cisterns’ CSF augmentation, fourth ventricle enlargement, and tonsillar ascent after PFD with superficial durotomy. These effect sizes provide a quantitative benchmark for sample-size estimation in future comparative surgical trials and for patient counseling on expected structural change at 6 months.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Afyonkarahisar Health Sciences University, 03030 Afyonkarahisar, Turkey",
    "Department of Radiology, Afyonkarahisar Health Sciences University, 03030 Afyonkarahisar, Turkey"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "İhsan Canbek",
      "orcid": "0000-0001-7740-196X"
    },
    {
      "affs": [
        0
      ],
      "name": "Muhammed Enes Demir",
      "orcid": "0009-0005-6522-582X"
    },
    {
      "affs": [
        1
      ],
      "name": "Emin Demirel",
      "orcid": "0000-0002-0675-3893"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehmet Gazi Boyacı",
      "orcid": "0000-0001-7329-2102"
    },
    {
      "affs": [
        0
      ],
      "name": "Serhat Yıldızhan",
      "orcid": "0000-0001-9394-5828"
    },
    {
      "affs": [
        0
      ],
      "name": "Serhat Korkmaz",
      "orcid": "0000-0003-0566-3594"
    },
    {
      "affs": [
        0
      ],
      "name": "Usame Rakip",
      "orcid": "0000-0001-7494-0335"
    },
    {
      "affs": [
        0
      ],
      "name": "Adem Aslan",
      "orcid": "0000-0001-9432-5399"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0zh032kbk2mdr.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208053",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705940/?tool=EBI",
  "id": "0zh032kbk2mdr",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8053",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2739|Spinal Dysraphism and Malformations"
    ]
  ],
  "openalex": "W7222532675",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705940/pdf/?tool=EBI",
  "pmcid": "PMC13705940",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/0zh032kbk2mdr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15208053",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8053"
    },
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "PMC:PMC13705940",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705940"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Spinal Dysraphism and Malformations",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Volumetric Morphometric Analysis of Posterior Fossa Structures Following Posterior Fossa Decompression with Superficial Durotomy in Chiari I Malformation",
  "title_text": "Volumetric Morphometric Analysis of Posterior Fossa Structures Following Posterior Fossa Decompression with Superficial Durotomy in Chiari I Malformation",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:34Z",
  "url": "https://research.draconitic.com/paper/0zh032kbk2mdr",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}