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Relevance: Magnetic resonance imaging (MRI) is more often used to confirm the presence of pectus excavatum then to assess compression changes in the heart at this level. Purpose: preoperative evaluation of PE according to magnetic resonance imaging. Materials and methods: A retrospective evaluation of chest MRI was performed in 38 patients (30 males, 8 females). The average age is 19.9 years (+/- 9 years).Cardiac MRI was performed on 1.5T General Electric Optima MR450w GEM scanner with 2D-FIESTA-C pulse sequences with functional assessment of left and right ventricles. Parameters for surgical treatment of PE were obtained - the Haller index, the correction index, the sternum rotation angle.Statistical search for the relationship between Haller index, correction index, sternum rotation angle and ejection fraction of the right ventricle was held. A value less than 0.05 was considered statistically significant.Results: In 92% of cases moderate and severe PE were diagnosed. No statistically significant correlation was obtained (P=0.777) between the values of the Haller index and the fraction of the right ventricle. When distinguishing three PE degrees according to the Haller index, a gradual decrease in the average value of the right ventricular ejection fraction was noted - for patients with mild PE, the fraction was 48%, for moderate deformity - 47%, for severe deformity 43%. Correlation between the values of the Haller index and the correction index (p0.05) was noted. The value of the angle of rotation of the sternum, which required modification of surgical intervention was detected in 44.7% of patients. Conclusion: Magnetic resonance imaging is an informative diagnostic method for PE without radiation exposure with the possibility of detailed preoperative assessment. Correlation between the values of the Haller index and the correction index (p0.05) was noted. MRI revealed a decrease in the ejection fraction of the right ventricle.
Relevance: Magnetic resonance imaging (MRI) is more often used to confirm the presence of pectus excavatum then to assess compression changes in the heart at this level. Purpose: preoperative evaluation of PE according to magnetic resonance imaging. Materials and methods: A retrospective evaluation of chest MRI was performed in 38 patients (30 males, 8 females). The average age is 19.9 years (+/- 9 years).Cardiac MRI was performed on 1.5T General Electric Optima MR450w GEM scanner with 2D-FIESTA-C pulse sequences with functional assessment of left and right ventricles. Parameters for surgical treatment of PE were obtained - the Haller index, the correction index, the sternum rotation angle.Statistical search for the relationship between Haller index, correction index, sternum rotation angle and ejection fraction of the right ventricle was held. A value less than 0.05 was considered statistically significant.Results: In 92% of cases moderate and severe PE were diagnosed. No statistically significant correlation was obtained (P=0.777) between the values of the Haller index and the fraction of the right ventricle. When distinguishing three PE degrees according to the Haller index, a gradual decrease in the average value of the right ventricular ejection fraction was noted - for patients with mild PE, the fraction was 48%, for moderate deformity - 47%, for severe deformity 43%. Correlation between the values of the Haller index and the correction index (p0.05) was noted. The value of the angle of rotation of the sternum, which required modification of surgical intervention was detected in 44.7% of patients. Conclusion: Magnetic resonance imaging is an informative diagnostic method for PE without radiation exposure with the possibility of detailed preoperative assessment. Correlation between the values of the Haller index and the correction index (p0.05) was noted. MRI revealed a decrease in the ejection fraction of the right ventricle.
The article provides a historical background of the etiopathogenesis, approaches to diagnosis and surgical treatment of pectus excavatum (PE). Foreign and domestic literary sources on morphological changes in the chest and the functional state of internal organs in patients with intracranial hypertension and correlations with diseases of other organs and systems were studied. Data on diagnostics and treatment tactics for PE are summarized and systematized.
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