Radiological assessment of children with pectus excavatum

Objective. To assess what degree of chest wall deformation changes statistically reliably after surgery, using pre- and postoperative radiological examination data. Methods. Radiological chest examinations were performed for 88 children before and after remedial operations. Pre- and postoperative chest radiograph and CT were performed to measure transversal chest width; sagittal left chest side depth, sagittal right chest side depth, sternovertebral distance, and vertebral body length. Derivative indices were also estimated: Vertebral index ( VI), Frontosagittal index ( FI), Haller index ( HI) and asymmetry index. Computerized assessment of data was used. For statistical analysis, the software " Statistica 6.0" was used. Results. Postoperatively VI increased approximately by 2.37 +/- 2.72, FI decreased by 4.60 +/- 4.34, and HI value increased approximately up by 0.45 +/- 0.49. Statistically significant deformation index difference before and after surgery was not detected when VI was below 26.2 ( p= 0.08), FI was above 32.9 ( p= 0.079) and HI was less than 3.12 ( p= 0.098). Conclusion. Preoperative CT and X- ray assessment of chest wall deformation degree is important for pediatric patients. The following deformation indices are indications for surgical treatment:26, FSI< 33 and HI> 3.1.