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.
Key words
pectus excavatum - anthropometry - non-invasive - computed tomography - Haller index
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
Telefon: +886 3 3281200 Ext.: 8227
Fax: +886 3 3287261
eMail: pyjchang@cgmh.org.tw