title: Chest fast MRI: an imaging alternative on pre-operative evaluation of Pectus Excavatum.
abstract: BACKGROUND
  Standard imaging methods in evaluating chest wall deformities, such as Pectus Excavatum (PE) in paediatric and adolescent patients, include baseline 2-view chest radiography and chest CT scan. Only few studies to date investigated the value of fast MRIin the pre operative assessment of patient affected by PE.
  
  
  OBJECTIVE
  To evaluate the efficacy of chest fast MRI in pre-operative management of patient affected by PE. To obtain the Haller Index (HI) and Asymmetry Index (AI) from chest fast MRI protecting patients from radiation exposure.
  
  
  METHODS
  We analyzed the data of 42 consecutive patients with severe PE who underwent minimally invasive repair between March 2007 and March 2010. All 42 patients received chest fast MRI, but only the first 5 in view of the results, were studied also with chest ultrafast CT scan. In both examinations, data at the deepest point of the depression were collected.
  
  
  RESULTS
  Severity indices of the deformity using HI and AI, collected from CT scan and fast MRI in the first 5 patients, were comparable. In the remaining 37 fast chest MRI offered good images of the chest wall deformities with no radiation exposure, detailing anatomical information such as displacement and rotation of the heart or great vessels anomalies.
  
  
  CONCLUSIONS
  This study suggests the use of chest MRI in pre operative workup for patients with PE to obtain severity indices (Haller Index and Asymmetry Index avoiding radiation exposure to paediatric patients.
authors.affiliation: Department of Pediatric Surgery, Anna Meyer Children's Hospital, 50100 Florence, Italy. r.lopicolo@meyer.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Lo Piccolo
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bongini
authors.forename: Massimo
authors.initials: M
authors.lastname: Basile
authors.forename: Sara
authors.initials: S
authors.lastname: Savelli
authors.forename: Caterina
authors.initials: C
authors.lastname: Morelli
authors.forename: Christian
authors.initials: C
authors.lastname: Cerra
authors.forename: Claudio
authors.initials: C
authors.lastname: Spinelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Messineo
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult