title: Limited, fast magnetic resonance imaging as an alternative for preoperative evaluation of pectus excavatum: a feasibility study.
abstract: OBJECTIVE
  The purpose of this study was to determine the reliability, feasibility, and image quality of a limited, fast magnetic resonance imaging (MRI) protocol for preoperative evaluation of pectus excavatum in a pediatric population referred for presurgical imaging.
  
  
  METHODS
  A total of 47 patients, median age 14 years, referred for preoperative imaging of pectus excavatum, underwent axial balanced steady-state free precession MRI of the chest, with a limited patient charge. Two pediatric radiologists independently conducted a blinded retrospective study. The Haller and asymmetry indices were calculated at the level of greatest anterior-posterior chest narrowing. In addition, right heart compression and image quality were subjectively assessed, and scan duration was determined.
  
  
  RESULTS
  Intraclass correlation coefficient reliability was between 0.85 and 0.98, indicating almost perfect agreement for quantitative measurements. Subjective evaluation of right heart compression and image quality showed moderate interreader agreement. Image quality was graded as good or excellent by both readers for all studies. No difference in the Haller index was observed between modalities in 3 patients on both computed tomographic scan and MRI (P = 0.2697). The median scan duration was 8 minutes.
  
  
  CONCLUSIONS
  Limited MRI is a reliable and cost-effective alternative for preoperative assessment of pectus excavatum. It is fast, free of ionizing radiation, and there is excellent interreader reliability for measurements of chest wall deformity.
authors.affiliation: Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Krista.Birkemeier@cchmc.org
authors.forename: Krista L
authors.initials: KL
authors.lastname: Birkemeier
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Podberesky
authors.forename: Shelia
authors.initials: S
authors.lastname: Salisbury
authors.forename: Suraj
authors.initials: S
authors.lastname: Serai
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D055815:Young Adult