Document Detail

Breathe in... breathe out... stop breathing: does phase of respiration affect the Haller index in patients with pectus excavatum?
MedLine Citation:
PMID:  22021545     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this article is to determine whether the phase of respiration at the time of imaging affects chest wall measurements and compression of internal structures in patients with pectus excavatum.
MATERIALS AND METHODS: Forty-seven patients (median age, 14 years) imaged for preoperative pectus excavatum underwent limited axial balanced steady-state free precession MRI of the chest at inspiration, expiration, and stop quiet breathing. Two radiologists, who were blinded to prior measurements, independently calculated the Haller index, asymmetry index, and sternal tilt in each phase of respiration. Compression of internal structures was recorded. Statistical comparison was performed.
RESULTS: The Haller index was significantly lower at inspiration, compared with stop quiet breathing and expiration, with medians (interquartile ranges) of 3.96 (3.27-4.61), 5.16 (4.02-6.48), and 5.09 (4.14-6.63), respectively (p < 0.0001 for both). No significant difference in Haller indexes was observed between expiration and stop quiet breathing (p = 0.1171). Of 11 patients with a Haller index less than 3.25 at inspiration, eight (72.7%) had an index greater than 3.25 on expiration and stop quiet breathing, which accounted for 17% (8/47) of all patients imaged. Compression of the liver or vascular structures was present in 24 (51%) patients. There was no significant difference in the asymmetry index, sternal tilt, or right heart compression between phases of respiration.
CONCLUSION: Obtaining the Haller Index at inspiration may result in a value significantly lower than that at expiration, potentially affecting surgical and financial decision making. Compression of the liver and vascular structures was observed in 51% of patients, but additional research is needed to determine the clinical significance of this finding.
Krista L Birkemeier; Daniel J Podberesky; Shelia Salisbury; Suraj Serai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  197     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-24     Completed Date:  2011-12-29     Revised Date:  2012-12-18    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  W934-9     Citation Subset:  AIM; IM    
Department of Radiology, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.
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MeSH Terms
Analysis of Variance
Funnel Chest / physiopathology*,  surgery
Magnetic Resonance Imaging / methods*
Statistics, Nonparametric
Young Adult
Comment In:
AJR Am J Roentgenol. 2012 Nov;199(5):W665; author reply W666   [PMID:  23096216 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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