Pectus deformities: tomographic analysis and clinical correlation
- 204 Downloads
To assess, with computed tomography (CT) studies, features of anterior chest wall development that can be related to different types of pectus deformities.
Materials and methods
From 71 patients with pectus deformities and chest coronal CT scans, 48 (40 male and 8 female), with a mean age of 15.8 years (ranging from 5 years to 38.4 years) were selected and divided into five groups, according to clinical type of deformity and image quality. A similar CT study was performed in a sixth group of 14 individuals with no underlying pectus deformity (control group), six male and eight female, mean age 19.3 years, (range 10.8 years to 30.5 years), totaling 62 subjects. Tomographic studies were performed on a 64-section CT scanner, with parameters varied according to the subject’s body mass index (BMI). Coronal reconstructions were used to assess six features of the sternum and costal cartilages in the groups. Two other factors, a sternal index, created to estimate the sternal body width, and the sternocostal angles, were also studied.
Feature I was noted in 13 patients and in no controls (P = 0.002), feature II in 39 patients and in one control (P = 0.000), feature III in 37 patients and in two controls (P = 0.002), and feature IV in two patients and in no controls (P = 0.002). The sternal index was significant to one group of patients.
The features studied and the index provide measurable and applicable data for the interpretation of anterior chest wall tomography, with possible implications for prognosis and treatment of different types of pectus deformities.
KeywordsChest Deformities Imaging studies of pectus deformities Pectus carinatum Pectus excavatum Studies on the development of the anterior chest wall by computed tomography
- 3.Currarino G, Silverman N. Premature obliteration of the sternum sutures and pigeon breast deformity. Radiology. 1958;70:352.Google Scholar
- 4.Gabrielsen TO, Ladyman GH. Early closure of sternal sutures and congenital heart disease. AJR Am J Roentgenol. 1963;89:375–83.Google Scholar
- 5.Haje SA, Raymundo JLP. Considerações sobre deformidades da parede torácica anterior e apresentação de tratamento conservador para as formas com componentes de protrusão. Rev Bras Orthop. 1979;14:167–78.Google Scholar
- 6.Kuhn JP. The Thorax. In: Silverman FN, editor. Caffey's pediatric X-ray diagnosis. Chicago: Year Book Medical Publishers Inc; 1985. pp. 1097–9.Google Scholar
- 11.Haje SA, Bowen JR, Harcke HT, Guttenberg ME, Bacon CR. Disorders in the sternum growth and pectus deformities: an experimental model and clinical correlation. Acta Orthop Bras. 1998;6:67–75.Google Scholar
- 12.Haje S, Haje DP. Tórax e cintura escapular. In: Hebert SK, Barros Filho TEP, Xavier R, Pardini Jr AG, editors. Ortopedia e traumatologia: princípios e prática. 4th ed. Porto Alegre: Artmed Editora; 2009. pp. 147–65.Google Scholar
- 13.Shimomura Y, Wezeman FH, Ray RD. The growth cartilage plate of the rat rib: cellular differentiation. Clin Orthop. 1973;(90):246–54.Google Scholar
- 14.Paterson AM. The Human sternum. Liverpool: Williams & Norgate, 1904.Google Scholar
- 16.Gray H. Gray's anatomy. Carmine D. Clemente, editor. 30th American Ed. Philadelphia: Lea & Febiger; 1985.Google Scholar
- 19.Haje SA, Haje DP. Abordagem ortopédica das deformidades pectus: 32 anos de estudos [Orthopaedic approach to pectus deformities: 32 years of studies]. Rev Bras Orthop. 2009;44:193–200.Google Scholar
- 21.Einsiedel E, Clausner A. Funnel chest. Psychological and psychosomatic aspects in children, youngsters and young adults. J Cardiovasc Surg. 1999;40:733–6.Google Scholar