Chest x-ray as a primary modality for preoperative imaging of pectus excavatum

Journal of Pediatric Surgery
Claudia MuellerSarah Bouchard

Abstract

Adolescents with a pectus excavatum mostly present with cosmetic complaints and rarely have significant physical limitations. The preoperative evaluation includes pulmonary functions tests, echocardiography, and chest computed tomography (CT) scan to measure the Haller index. In most patients, the chest CT is performed only to measure the Haller index. The purpose of this study was to evaluate whether indices measured on chest radiograph (CXR) and CT scan are comparable. Cases of pectus excavatum treated with the minimally invasive approach in the last year were prospectively collected. In patients for whom a preoperative CXR and CT scan were available, an index was measured using both imaging modalities and compared. Both preoperative imaging studies were available in 12 patients. The mean Haller indices on CT scan and CXR were 3.97 and 4.08, respectively. The Pearson correlation score between the 2 groups was 0.984. We propose that the Haller index measured on CT scan be replaced by CXR measurement in asymptomatic patients in whom a chest CT scan is otherwise not necessary. This will limit radiation exposure to children. When in doubt, a CT scan of the chest can be used for the preoperative evaluation.

References

Jul 1, 1988·Journal of Pediatric Surgery·R C Shamberger, K J Welch
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Oct 1, 1987·Journal of Pediatric Surgery·J A HallerS A Lietman
Feb 13, 2001·AJR. American Journal of Roentgenology·D BrennerW Berdon
Mar 2, 2005·Radiologic Clinics of North America·Lane F Donnelly

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Citations

Oct 9, 2009·Pediatric Radiology·Amit S RattanAlan S Brody
Dec 31, 2009·Medical & Biological Engineering & Computing·Pei-Yeh ChangYu-Tai Ching
May 17, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ti-Hei WuYeung-Leung Cheng
Aug 19, 2014·Seminars in Ultrasound, CT, and MR·Zahir U SarwarStephen C O'Connor
Jan 24, 2012·European Journal of Radiology·Csilla Balassy, Stephen F Miller
Oct 27, 2010·Thoracic Surgery Clinics·Donald Nuss, Robert E Kelly
Jan 13, 2009·Pediatric Clinics of North America·Janaki Gokhale, Steven M Selbst
Aug 4, 2015·Journal of Pediatric Surgery·Patrick M PostonJoseph W Turek
Nov 18, 2008·American Journal of Medical Genetics. Part a·Meike RybczynskiYskert von Kodolitsch
Sep 1, 2016·Journal of Pediatric Surgery·Michael A McHughJoseph W Turek
Oct 25, 2016·The Annals of Thoracic Surgery·Krystian PawlakWojciech Dyszkiewicz
Apr 2, 2010·Clinical Pediatrics·Kurt B Angstman, Mioki R Myszkowski
Sep 13, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Dalia SzaferJames Wall
Feb 21, 2014·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Patrick M PostonJoseph W Turek
May 17, 2018·The International Journal of Cardiovascular Imaging·Andrea SonaglioniClaudio Anzà
Aug 21, 2016·Interactive Cardiovascular and Thoracic Surgery·Johan van der MerweFrank Van Praet
Feb 9, 2019·Journal of Pediatric Surgery·Elissa PortMarleta Reynolds
Jan 18, 2021·American Journal of Surgery·Yangyang R YuSohail R Shah
Jun 16, 2019·The Annals of Thoracic Surgery·Jordan S TaylorStephanie D Chao

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