Pediatric Radiology

, Volume 40, Issue 2, pp 168–172

Pectus excavatum imaging: enough but not too much

  • Amit S. Rattan
  • Tal Laor
  • Frederick C. Ryckman
  • Alan S. Brody
Original Article

DOI: 10.1007/s00247-009-1417-0

Cite this article as:
Rattan, A.S., Laor, T., Ryckman, F.C. et al. Pediatr Radiol (2010) 40: 168. doi:10.1007/s00247-009-1417-0



Pectus excavatum (pectus) is a common congenital deformity of the chest wall resulting in a diminished anterior-posterior dimension. Chest CT has become a common study for preoperative assessment. CT evaluation was initially described using a single CT image; it is now common to perform a CT of the entire chest to evaluate pectus.


To evaluate the efficacy of chest radiographs compared to chest CT in identifying additional clinically significant abnormalities in the preoperative evaluation of children with pectus.

Materials and methods

We reviewed the chest CT scans of 209 children and young adults who had been evaluated for possible surgical repair of pectus. Additional abnormalities were categorized as (1) incidental, (2) potentially significant, and (3) findings that affected the decision to perform surgery. Chest radiographs were reviewed for category 3 findings.


Seventy-six scans showed additional abnormalities, five in group 2 and two in group 3. Both group 3 findings, a vascular ring and an acute pneumonia, were identified on chest radiographs.


Conventional radiographs identified clinically important findings in children and young adults evaluated for pectus surgery. Radiation risks and medical costs might be substantially decreased by obtaining a chest radiograph and using a limited CT technique when a CT scan is ordered for the purpose of obtaining a Haller index.


Pectus excavatumCTChest radiographyThoracicChildren

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Amit S. Rattan
    • 1
  • Tal Laor
    • 1
  • Frederick C. Ryckman
    • 2
  • Alan S. Brody
    • 1
  1. 1.Radiology DepartmentCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Pediatric and Thoracic Surgery DepartmentCincinnati Children’s Hospital Medical CenterCincinnatiUSA