Published in:
01-03-2015 | Chest
Morphologic assessment of thoracic deformities for the preoperative evaluation of pectus excavatum by magnetic resonance imaging
Published in: European Radiology | Issue 3/2015
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Objective
To assess whether MRI is a suitable modality for the preoperative assessment and quantification of pectus excavatum.
Methods
A total of 69 patients (57 male, 12 female; median age 15 years, range 5–35 years) with pectus excavatum were evaluated preoperatively using standardized MRI sequences on 1.5- and 3-Tesla systems (T2-HASTE/inspiration and expiration, T1-VIBE, T2-TRUFI free-breathing, T2-BLADE). The MR sequences were analysed for quality semiquantitatively. The Haller index, correction index, sternal rotation angle and asymmetry index were assessed; correlations between these indices and changes in inspiration and expiration were evaluated.
Results
T2-HASTE was the best sequence to assess pectus excavatum morphology, with a higher quality at 3 T than at 1.5 T. All indices could be assessed in every patient. A total of 37 patients had a symmetric deformity, 32 patients an asymmetric deformity. The Haller index correlated significantly (p < 0.001) with the correction index, both becoming higher in expiration. The asymmetry index correlated with the sternal rotation angle (p < 0.001) and did not change significantly in expiration (p = 0.28).
Conclusions
Thoracic MRI is suitable for the preoperative evaluation of patients with pectus excavatum. An exact morphologic assessment is possible without radiation exposure as well as the determination of several indices to quantify the deformities.
Key points
• MRI is a suitable method for the preoperative evaluation of pectus excavatum.
• MRI allows an exact morphological assessment preoperatively.
• The determination of the Haller index to quantify the deformity is possible.
• The correction index, sternal rotation angle and asymmetry index can also be assessed.
• Sequences in inspiration and expiration should be acquired.