Eur J Pediatr Surg 2010; 20(2): 82-84
DOI: 10.1055/s-0029-1241819
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

A Method for the Non-invasive Assessment of Chest Wall Growth in Pectus Excavatum Patients

P.-Y. Chang1 , C.-H. Chang2 , J.-Y. Lai1 , J.-C. Chen1 , D.-B. Perng2 , Q. Zeng3
  • 1Chang Gung Children's Hospital, Pediatric Surgery, Taoyuan, Taiwan, Province of China
  • 2National Chiao Tung University, Industrial Engineering and Management, Hsinchu, Taiwan, Province of China
  • 3Beijing Children Hospital, Pediatric Surgery, Beijing, China
Further Information

Publication History

received May 19, 2009

accepted after revision September 25, 2009

Publication Date:
06 November 2009 (online)

Abstract

Introduction: Various scales and measurement methods including X-rays and computed tomography (CT) have been used to quantify the degree of deformity in pectus excavatum. This study describes a non-invasive method for recording the deviation of the anterior chest wall (ACW) in pectus excavatum (PE) patients. Data obtained using this non-invasive method were compared with CT data.

Materials and Methods: Twenty-one patients treated at our institutions between June 2008 and February 2009 were enrolled in this study. All patients underwent CT and thermal plastic strip measurement. A thermal plastic strip was positioned and taped to the supine patient's ACW at the skin level from the posterior axillary line, over the depressed sternum, to the contralateral posterior axillary line and used to create a casting of the ACW.

Results: The funnel index (FI) was defined as the width of the ACW divided by its height; the concave index (CI) was defined as the breadth of the depressed area of the funnel chest divided by its depth. Pearson's correlation coefficient was used to compare the FI and CI obtained with the thermal plastic strip method and with CT; measurements obtained with both methods were found to correlate well (FI: r2=0.965; CI: r2=0.947).

Conclusions: The thermal plastic strip measurement method provides a two-dimensional record of the shape of the anterior chest wall. The measurement can be repeated, does not involve the patient being exposed to radiation, and offers a good longitudinal assessment of chest wall growth in PE patients.

References

  • 1 Chang NC, Chang PY, Perng DB. Feature extraction and analysis of head ring images.  Chin J Med Biol Eng. 2000;  20 83-91
  • 2 Chung CS, Myrianthopoulos NC. Analysis of epidemiologic factors in congenital malformations.  Birth Defects Orig Artic Ser. 1975;  11 1-22
  • 3 Don S. Radiosensitivity of children: potential for overexposure in CR and DR and magnitude of doses in ordinary radiographic examinations.  Pediatr Radiol. 2004;  34 S167-S172
  • 4 Haller JA, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: A preliminary report.  J Pediatr Surg. 1987;  22 904-906
  • 5 Kamata S, Usui N, Sawai T. et al . Radiographic changes in the diaphragm after repair of congenital diaphragmatic hernia.  J Pediatr Surg. 2008;  43 2156-2160
  • 6 Mueller C, Saint-Vil D, Bouchard S. Chest x-ray as a primary modality for preoperative imaging of pectus excavatum.  J Pediatr Surg. 2008;  43 71-73
  • 7 Nakagawa Y, Uemura S, Nakaoka T. et al . Evaluation of the Nuss procedure using pre- and postoperative computed tomographic index.  J Pediatr Surg. 2008;  43 518-521
  • 8 Poncet P, Kravarusic D, Richart T. et al . Clinical impact of optical imaging with 3-D reconstruction of torso topography in common anterior chest wall anomalies.  J Pediatr Surg. 2007;  42 898-903
  • 9 Rebeis EB, Campos JR, Fernandez A. et al . Anthropometric index for pectus excavatum.  Clinics. 2007;  62 599-606
  • 10 Shamberger RC, Welch KJ. Cardiopulmonary function in pectus excavatum.  Surg Gynecol Obstet. 1988;  166 383-391
  • 11 Van Vilmmeren LA, Takken T, Van Adrichem LNA. Plagiocephalometry: a non-invasive method to quantify asymmetry of the skull; A reliability study.  Eur J Pediatr. 2006;  165 149-157

Correspondence

Dr. Pei-Yeh Chang

Chang Gung Children's Hospital

Pediatric Surgery

Taoyuan, Taiwan

Province of China

Phone: +886 3 3281200 Ext.: 8227

Fax: +886 3 3287261

Email: pyjchang@cgmh.org.tw

    >