title: Morphologic assessment of thoracic deformities for the preoperative evaluation of pectus excavatum by magnetic resonance imaging.
abstract: OBJECTIVE
  To assess whether MRI is a suitable modality for the preoperative assessment and quantification of pectus excavatum.
  
  
  METHODS
  A total of 69 patients (57 male, 12 female; median age 15 years, range 5-35 years) with pectus excavatum were evaluated preoperatively using standardized MRI sequences on 1.5- and 3-Tesla systems (T2-HASTE/inspiration and expiration, T1-VIBE, T2-TRUFI free-breathing, T2-BLADE). The MR sequences were analysed for quality semiquantitatively. The Haller index, correction index, sternal rotation angle and asymmetry index were assessed; correlations between these indices and changes in inspiration and expiration were evaluated.
  
  
  RESULTS
  T2-HASTE was the best sequence to assess pectus excavatum morphology, with a higher quality at 3 T than at 1.5 T. All indices could be assessed in every patient. A total of 37 patients had a symmetric deformity, 32 patients an asymmetric deformity. The Haller index correlated significantly (p < 0.001) with the correction index, both becoming higher in expiration. The asymmetry index correlated with the sternal rotation angle (p < 0.001) and did not change significantly in expiration (p = 0.28).
  
  
  CONCLUSIONS
  Thoracic MRI is suitable for the preoperative evaluation of patients with pectus excavatum. An exact morphologic assessment is possible without radiation exposure as well as the determination of several indices to quantify the deformities.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Langenbeckstr 1, 55131, Mainz, Germany, andre.lollert@unimedizin-mainz.de.
authors.forename: A
authors.initials: A
authors.lastname: Lollert
authors.forename: J
authors.initials: J
authors.lastname: Funk
authors.forename: N
authors.initials: N
authors.lastname: Tietze
authors.forename: S
authors.initials: S
authors.lastname: Turial
authors.forename: K
authors.initials: K
authors.lastname: Laudemann
authors.forename: C
authors.initials: C
authors.lastname: Düber
authors.forename: G
authors.initials: G
authors.lastname: Staatz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005660:Funnel Chest / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D008297:Male; D011300:Preoperative Care / Q000379:methods; D012119:Respiration; D012189:Retrospective Studies; D012399:Rotation; D012680:Sensitivity and Specificity; D013249:Sternum / Q000502:physiology; D055815:Young Adult