Radiological assessment of children with pectus excavatum.

ABSTRACT

OBJECTIVE: To assess what degree of chest wall deformation changes statistically reliably after surgery, using pre- and postoperative radiological examination data. METHODS: Radiological chest examinations were performed for 88 children before and after remedial operations. Pre- and postoperative chest radiograph and CT were performed to measure transversal chest width; sagittal left chest side depth, sagittal right chest side depth, sternovertebral distance and vertebral body length. Derivative indices were also estimated Vertebral index (VI), Frontosagittal index (FI), Haller index (HI) and asymmetry index. Computerized assessment of data was used. For statistical analysis, the software "Statistica 6.0" was used. RESULTS: Postoperatively VI increased approximately by 2.37+/-2.72, FI decreased by 4.60+/-4.34 and HI value increased approximately up by 0.45+/-0.49. Statistically significant deformation index difference before and after surgery was not detected when VI was below 26.2 (p=0.08), FI was above 32.9 (p=0.079) and HI was less than 3.12 (p=0.098). CONCLUSION: Preoperative CT and X-ray assessment of chest wall deformation degree is important for pediatric patients. The following deformation indices are indications for surgical treatment VI>26, FSI< 33 and HI>3.1.