Citation, DOI, disclosures and article data
Citation:
Hacking C, Twining's line (posterior cranial fossa). Reference article, Radiopaedia.org (Accessed on 11 Oct 2024) https://doi.org/10.53347/rID-191687
Disclosures:
At the time the article was created Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Craig Hacking's current disclosures
Disclosures:
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Craig Hacking's current disclosures
Twining's line (a.k.a tuberculum torcula line) is a midline measurement used in the volumetric assessment of the posterior cranial fossa and of particular relevance in Chiari I malformations 1. The angle between the line and the tentorium is also used for similiar purposes 1. It has also been used to describe mass effect in the posterior cranial fossa due to cerebellar infarction 2.
Basilar invagination can be assessed with the Klaus height index which is the perpendicular distance between Twining's line and the tip of the dens of C2.
Measurement
On the midsagittal CT or MRI image, Twining's line is the distance from the tuberculum sellae to the torcula.
History and etymology
The line was described by British radiologist Edward Wing Twining (1887-1939) who also described the radiographic appearance of the inferior accessory fissure of the lung 3.
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1. Karagöz F, Izgi N, Kapíjcíjoğlu Sencer S. Morphometric Measurements of the Cranium in Patients with Chiari Type I Malformation and Comparison with the Normal Population. Acta Neurochir (Wien). 2002;144(2):165-71; discussion 171. doi:10.1007/s007010200020 - Pubmed
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2. Koh M, Phan T, Atkinson J, Wijdicks E. Neuroimaging in Deteriorating Patients with Cerebellar Infarcts and Mass Effect. Stroke. 2000;31(9):2062-7. doi:10.1161/01.str.31.9.2062 - Pubmed
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3. Isherwood I. Edward Wing Twining, 1887-1939. (1995) AJNR. American journal of neuroradiology. 16 (10): 2077-80. Pubmed
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