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Table of Contents > Abs + Ref
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Yonsei Med J. 2009 Jun;50(3):385-390.
Published online 2009 June 23.  doi: 10.3349/ymj.2009.50.3.385.
© Copyright: Yonsei University College of Medicine 2009
Development of New Cardiac Deformity Indexes for Pectus Excavatum on Computed Tomography: Feasibility for Pre- and Post-Operative Evaluation
Miyoung Kim,1 Ki Yeol Lee,1 Hyung Joo Park,2 Hee-Young Kim,3 Eun-Young Kang,1 Yu Whan Oh,1 Bo Kyung Seo,1 Bo Kyung Je,1 and Eun Jung Choi1
1Department of Diagnostic Radiology, Korea University Hospital, Ansan, Korea.
2Department of Thoracic Surgery, Korea University Hospital, Ansan, Korea.
3Department of Biostatistics, Korea University Hospital, Ansan, Korea.

Corresponding author: Dr. Ki Yeol Lee, Department of Diagnostic Radiology, Korea University Hospital, 516 Gojan-dong, Ansan 425-707, Korea. Tel: 81-31-412-5227, Fax: 81-31-412-5224, Email: kiylee@korea.ac.kr
Received August 25, 2008; Revised October 29, 2008; Accepted October 29, 2008.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

The aim of this study was to evaluate new cardiac deformity indexes (CDIs) for diagnosis of pectus excavatum as well as morphological assessment of heart on computed tomography (CT).

Materials and Methods

We retrospectively evaluated the CT images of the control group (n=200), and the pectus excavatum before and after correction groups (n=178), and calculated the CDIs; cardiac compression index (CCI), and cardiac asymmetry index (CAI). We also calculated chest wall compression index (CWCI) and asymmetry index (CWAI) on the axial images. We performed logistic regression analysis using each index and age as predictor variables.

Results

The CDIs (CCI and CAI) were significant (p < 0.05) in the diagnosis of pectus excavatum, regardless of age (p = 0.4033, p = 0.8113). The CWCI and CWAI were significant (p < 0.05) and significantly affected by age (p < 0.05). If we selected 1.82 as the cutoff of the CCI, the sensitivity and specificity were 99.4% and 98%, respectively. The following cutoffs and the sensitivity and specificity were obtained: 1.15 for the CAI gave 94.4% and 94.5%, 3.05 for the CWCI gave 92.1% and 92%, and 1 for the CWAI gave 62.4% and 65%, respectively. The CCI after repair improved from 2.83 ± 0.84 to 1.84 ± 0.33, while the CWCI improved from 4.49 ± 1.61 to 2.57 ± 0.44.

Conclusion

CDIs such as the CCI and CAI may be potentially useful to detect and estimate repair for pectus excavatum.

Keywords: Pectus excavatum, minimally invasive repair of pectus excavatum (MIRPE), CT scan, cardiac deformity index.
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