Investigation of intrathoracic morphology in computed tomography images of individuals with anterior chest wall deformity

Abstract

Objective: Morphological determination of the location, position, and level of the intrathoracic organs in relation to the thoracic vertebrae of individuals with anterior chest wall deformity using computed tomography (CT) images. Study Design: Retrospective study. Place and Duration of Study: Kayseri Health Practice and Research Center, University of Health Sciences Turkey, Kayseri, Turkey, January 2020–January 2022. Subjects and Methods: In the study, clinical and morphological measurements of intrathoracic organs were performed on thorax CT images of 80 patients with pectus excavatum (PE) and 70 pectus carinatum (PC) diagnose. Results: The mean Haller index (HI) of patients with PE was measured at the highest T11 (Female: 3.79 cm, Male: 3.67 cm) and lowest at T7 (Female: 3.41 cm, Male: 3 cm). The mean HI at all levels (T5-T11) was higher than healthy individuals (P < 0.05). PE severity was higher in women than men. Due to the increase in the severity of PE, it was determined that the heart was displaced in the left anterior, left posterior and downward directions, and the cardiothoracic ratio (CTR) increased. In severe cases, it was seen that the aorta was located on the left side of the corpus vertebrae in the left posterior region. In patients with PC, the most severe HI value was measured at the T7 level (1.54 cm) in women and at the T9 level (1.42 cm) in men. There was no significant difference between the CTRs of patients with PC and healthy individuals. Conclusion: We think that knowing the location, position, and levels of the organs in cases with anterior chest wall deformity will shed light on clinical studies.