Measurement Of Thoracic Cage With Three-dimensional Reconstruction Of MSCT In3～12Years Old Children In China

Objective:Pectus excavatum is the most common congenital chest wall deformity, Haller index is acknowledged as one of the best indicators into evaluating degree of sternum depression in Pectus excavatum; Currently Pectus excavatum treatment mainly adopts Nuss, the best age for operation is between6to12years old, and can be extended3to15years old, in clinical practice, generally make the age of Nuss surgical patients controllable over3years old. The success of Nuss surgical is largely based on support plate forming in advance suited for the curvature of the anterior chest wall for patients, so what extent of Nuss surgical correction needed, it also must consider what extent of what thoracic would grow after2to3years, it will need to have a quantitative standard of thoracic and its development trend, up to now, there are no measurement for normal children’s thoracic value and Haller index based on MSCT in domestic, so this project collected children’s chest CT slice of3to12years old, to measure normal thoracic diameter lines and Haller index of children and hopes to provide some beneficial reference for the basic researches of children thoracic growth and development and the follow-up.Methods:We choosed411cases of chest CT slice sample of3to12years old children without thoracic deformity diagnosed in our hospital from May2011to December2012. According to the gender, they were divided into two groups:male, female, a total of214cases of male group, female group had197cases. According to age groups, the gradient was one year, male and female had10groups each, a total of20groups; Measuring left and right sides height of thoracic and thoracic maximum inner diameter, and thoracic anteroposterior diameter of the top and bottom of sternum,and Haller index. Each variable measured three times, and took the average; And all the data entry had been done by the author, using SPSS software for data analysis.Results:All lines of thoracic were positively correlated with age, growing with age; Child thoracic height and the maximum inner diameter of the growth change with a certain synchronization,Child thoracic height and the maximum inner diameter growth peak at the ages of3to7,7to11years old growing relatively stable, showing growth plateau,and growth rate would increase again at the ages of11to12. Thoracic anteroposterior diameter growth changes with thoracic height and the maximum inner diameter growth change is not fully synchronized.Haller index of Male and female grew with age, and growth rate roughly were on the rise. Haller index volatility were between2.33～2.52in3to12 years old in male, Haller index volatility were between2.31～2.63in female; the differences of Haller index between male and female in different age groups had no statistical significance.Conclusion:1. Chinese children thoracic growth and development had its certain uniqueness; the measured value of this study could make plan for Pectus excavatum corrective surgery, and provide some useful help for postoperative follow-up.2. Haller index was a relatively stable parameter, and could be used as an important reference index for diagnosis and treatment of Pectus excavatum.