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Clivus

The clivus is a sloping bony structure located at the skull base, forming the central portion of the occipital bone anterior to the foramen magnum and extending to the dorsum sellae of the sphenoid bone. It forms a key anatomical region separating the posterior cranial fossa from the sphenoid sinus and houses important neurovascular structures in close proximity, including the basilar artery and the brainstem. Knowledge of its normal imaging features is essential in identifying pathological processes affecting the skull base.

Clivus: MRI Appearance

T1-Weighted Images

  • The normal adult clivus appears as intermediate signal intensity on T1-weighted images.

  • In children and young adults, the clivus often demonstrates high T1 signal due to residual red marrow, gradually decreasing with age as fatty marrow replaces red marrow.

  • The cortex appears as a thin, low-signal-intensity line outlining the clivus.

T2-Weighted Images

  • The clivus generally shows intermediate to high signal intensity on T2-weighted images.

  • The marrow content influences the signal; in younger patients, the higher water content of red marrow results in relatively higher T2 signal.

  • Fatty marrow in older adults appears more intermediate to slightly hyperintense on T2.

STIR (Short Tau Inversion Recovery)

  • STIR images demonstrate the clivus as homogeneously low signal due to fat suppression.

  • Any abnormal marrow signal (e.g., edema, infiltration) appears bright on STIR, helping differentiate normal from pathological marrow processes.

Clivus: CT Appearance

  • On CT, the clivus is seen as a dense, corticated bony structure with well-defined margins.

  • The trabecular pattern is usually visible within the clivus, especially in non-sclerotic bone.

MRI image

Clivus mri axial image -img-00000-00000

X Ray image

Clivus