Ces radiol. 2014, 68(4):298-310

Radiological evaluation in patients with pectus excavatumReview article

Martin Lučenič, Miroslav Janík, Peter Juhos, Roman Benej, Svetozár Harušiak
Klinika hrudníkovej chirurgie SZU a UN, Bratislava, Slovenská republika

Pectus excavatum is the most common inborn deformity of the chest. Severe deformity is considered to be an absolute indication for surgical correction. Indication criterias are dependent on multiple factors, but the severity of the malformation based on radiologic assessment is the most important. Standard chest X-ray and native MDCT examination offer the evaluation of the severity of the deformity with the use of basic indices like Haller, correctional, vertebral or fronto-sagittal index. The evolution of minimally invasive pectus excavatum repair (MIRPE) and high number of asymmetric deformities treated with this procedure has brought the necessity for the creation of new indices. These indices help surgeons to individually preshape implanted bar in complex cases. Authors concentrate on complications of both procedures and their typical radiological findings.

Keywords: chest X-ray, MDCT, MIRPE, pectus excavatum, highly modified Ravitch repair

Accepted: September 15, 2014; Published: December 1, 2014  Show citation

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Lučenič M, Janík M, Juhos P, Benej R, Harušiak S. Radiological evaluation in patients with pectus excavatum. Ces radiol. 2014;68(4):298-310.
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    References

    1. Goretsky MJ, Kelly RE Jr., Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med Clin 2004; 15(3): 455-471. Go to original source... Go to PubMed...
    2. Feng J, Hu T, Liu W, et al. The biomechanical, morphologic, and histochemical properties of the costal cartilages in children with pectus excavatum. J Pediatr Surg 2001; 36(12): 1770-1776. Go to original source... Go to PubMed...
    3. Fokin AA, Steuerwald NM, Ahrens WA, et al. Anatomical, histologic and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2009; 21(1): 44-57. Go to original source... Go to PubMed...
    4. Chest Wall Deformities. In: Puri P, Holwarth M (eds.) Pediatric Surgery: Diagnosis and management. Berlin-Heidelberg: Springer Verlag 2009; 247-256. Go to original source...
    5. Park HJ, Lee SY, Lee CS, Youm W, Lee KR. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg 2004; 77(1): 289-295. Go to original source... Go to PubMed...
    6. Haller Jr JA, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectusexcavatum surgery: A preliminary report. Journal of Pediatric Surgery 1987; 22(10): 904-906. Go to original source... Go to PubMed...
    7. Kilda A, Basevicius A, Barauskas V, et al. Radiological assessment of children with pectus excavatum. The Indian Journal of Pediatrics 2007; 74(2): 143-147. Go to original source... Go to PubMed...
    8. Calloway EH, Chhotani AN, Lee YZ, et al. Three-dimensional computed tomography for evaluation and management of children with complex chest wall anomalies: useful information or just pretty pictures? Journal of Pediatric Surgery 2011; 46(4): 640-647. Go to original source... Go to PubMed...
    9. Raichura N, Entwisle J, Leverment J, et al. Breath-hold MRI in evaluating patients with pectus excavatum. British Journal of Radiology 2001; 74(884): 701-708. Go to original source... Go to PubMed...
    10. Birkemeier KL, Podberesky DJ, Salisbury S, et al. Breathe in... breathe out... stop breathing: does phase of respiration affect the Haller index in patients with pectus excavatum? AJR Am J Roentgenol 2011; 197(5): W934-939. Go to original source... Go to PubMed...
    11. Albertal M, Vallejos J, Bellia G, et al. Changes in chest compression indexes with breathing underestimate surgical candidacy in patients with pectus excavatum: A computed tomography pilot study. Journal of Pediatric Surgery 2013; 48(10): 2011-2016. Go to original source... Go to PubMed...
    12. Daunt SW, Cohen JH, Miller SF. Age-related normal ranges for the Haller index in children. Pediatr Radiol 2004; 34(4): 326-330. Go to original source... Go to PubMed...
    13. St. Peter SD, Juang D, Garey CL, et al. A novel measure for pectus excavatum: the correction index. Journal of Pediatric Surgery 2011; 46(12): 2270-2273. Go to original source... Go to PubMed...
    14. Poston PM, Patel SS, Rajput M, et al. The Correction Index: Setting the Standard for Recommending Operative Repair of Pectus Excavatum. The Annals of Thoracic Surgery 2014; 97(4): 1176-1180. Go to original source... Go to PubMed...
    15. Mueller C, Saint-Vil D, Bouchard S. Chest x-ray as a primary modality for preoperative imaging of pectus excavatum. Journal of Pediatric Surgery 2008; 43(1): 71-73. Go to original source... Go to PubMed...
    16. Khanna G, Jaju A, Don S, et al. Comparison of Haller index values calculated with chest radiographs versus CT for pectus excavatum evaluation. Pediatr Radiol 2010; 40(11): 1763-1767. Go to original source... Go to PubMed...
    17. Wu TH, Huang TW, Hsu HH, et al. Usefulness of chest images for the assessment of pectus excavatum before and after a Nuss repair in adults. European Journal of Cardio-thoracic Surgery 2013; 43(2): 283-287 Go to original source... Go to PubMed...
    18. Backer OG, Brunner S, Larsen V. Radiologic Evaluation of Funnel Chest. Acta Radiologica, 1961; 55(4): 249-256. Go to original source... Go to PubMed...
    19. Ohno K, Nakahira M, Takeuchi S, et al. Indications for surgical treatment of funnel chest by chest radiograph. Pediatr Surg Int 2001; 17(8): 591-595. Go to original source... Go to PubMed...
    20. Rattan A, Laor T, Ryckman F, et al. Pectus excavatum imaging: enough but not too much. Pediatric Radiology 2010; 40(2): 168-172. Go to original source... Go to PubMed...
    21. Arn PH, Scherer LR, Haller JA Jr, et al. Outcome of pectus excavatum in patients with Marfan syndrome and in the general population. The Journal of pediatrics 1989; 115(6): 954-958. Go to original source... Go to PubMed...
    22. Krasopoulos G, Goldstraw P. Minimally invasive repair of pectus excavatum deformity. European Journal of Cardio-thoracic Surgery 2011; 39(2): 149-158. Go to original source... Go to PubMed...
    23. Hong JY, Suh SW, Park HJ, et al. Correlations of adolescent idiopathic scoliosis and pectus excavatum. Journal Of Pediatric Orthopedics 2011; 31(8): 870-874. Go to original source... Go to PubMed...
    24. Wang Y, Chen G, Xie L et al. Mechanical factors play an important role in pectus excavatum with thoracic scoliosis. Journal of Cardiothoracic Surgery 2012; 7: 118-120. Go to original source... Go to PubMed...
    25. Merks JHM, Smets AM, Van Rijn RR, et al. Prevalence of rib anomalies in normal Caucasian children and childhood cancer patients. European Journal of Medical Genetics, 2005; 48(2): 113-129. Go to original source... Go to PubMed...
    26. Knudsen MR, Nyboe C, Hjortdal VE, et al. Routine postoperative chest X-ray is unnecessary following the Nuss procedure for pectus excavatum. Interactive CardioVascular and Thoracic Surgery 2013; 16(6): 830-833. Go to original source... Go to PubMed...
    27. Kilda A, Lukosevicius S, Barauskas, V, et al. Radiological changes after Nuss operation for pectus excavatum. Medicina (Kaunas), 2009; 45 (9): 699-705. Go to original source...
    28. Pilegaard HK. Extending the use of Nuss procedure in patients older than 30 years. European Journal of Cardio-thoracic Surgery 2011; 40(2): 334-338. Go to original source... Go to PubMed...
    29. Nyboe C, Knudsen MR, Pilegaard HK. Elective pectus bar removal following Nuss procedure for pectus excavatum: a single-institution experience. European Journal of Cardio-thoracic Surgery 2011; 39(6): 1040-1041. Go to original source... Go to PubMed...
    30. Castellani C, Saxena AK, Zebedin D, et al. Pleural and pericardial morbidity after minimal access repair of pectus excavatum. Langenbeck's Archives of Surgery 2009; 394(4): 717-721. Go to original source... Go to PubMed...
    31. Williams AM, Crabbe DC. Pectus deformities of the anterior chest wall. Paediatr Respir Rev 2003; 4(3): 237-242. Go to original source... Go to PubMed...
    32. Nuss D. Minimally invasive surgical repair of pectus excavatum. Seminars in Pediatric Surgery 2008; 17(3): 209-217. Go to original source... Go to PubMed...
    33. Castellani C, Schalamon J, Saxena A, et al. Early complications of the Nuss procedure for pectus excavatum: a prospective study. Pediatric Surgery International 2008; 24(6): 659-666. Go to original source... Go to PubMed...

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