Shi Zhuo, Li Jianhua, Gao Yue, Huang Ting, Liang Liang, Xu Weize, Shu Qiang
Department of Cardiovascular and Thoracic Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2018 May 25;47(3):289-293. doi: 10.3785/j.issn.1008-9292.2018.06.12.
To evaluate the application of cameral-type three-dimensional (3D) scan in the assessment of funnel chest.
Eighty children with funnel chest were collected from the Children's Hospital, Zhejiang University School of Medicine during June 2016 and December 2017. All patients underwent routine CT scan. In the same selected mediastinal window, the lowest point of the depression to the front of the spine was the anteroposterior diameter (A), and the maximum left to right diameter was B (which was perpendicular to A). The ratio B/A was calculated to get CT Haller index (CT-HI). In the same period, the chest wall scan was performed by EinScan-Pro 3D scanner, and the image was analyzed by GeoMedic image software. On the plane of the most concave point of the sternum, the distance from the lowest point of the skin to the back skin was the anteroposterior diameter (A), the maximum plane diameter was measured on the same plane (B), and the ratio B/A was the 3D-Haller index (3D-HI). Pearson correlation analysis was used to analyze the consistency of the two measurements. Kappa test was used to analyze the consistency of surgical indication based on cutoff value of CT-HI and 3D-HI.
All children were able to cooperate with CT and 3D chest wall surface scan. The mean value of CT-HI was 3.82±0.96, and that of 3D-HI was 1.82±0.23. Pearson correlation analysis showed that the correlation coefficient between CT-HI and 3D-HI was 0.823 (<0.01). When CT-HI > 3.2 and 3D-HI > 1.7 were set as cutoff values for indication of operation, the sensitivity and specificity of 3D-HI were 90.48% and 100.0%, respectively. 3D-HI was well consistent with CT-HI in surgical indication (Kappa=0.801).
s 3D scan can be used to assess the funnel chest in children, and 3D-HI>1.7 can be used as the cutoff value for surgical indication.
评估摄像头式三维（3D）扫描在漏斗胸评估中的应用。
收集2016年6月至2017年12月浙江大学医学院附属儿童医院的80例漏斗胸患儿。所有患者均接受常规CT扫描。在选定的同一纵隔窗中，凹陷最低点至脊柱前方的距离为前后径（A），左右最大直径为B（与A垂直）。计算B/A比值以获得CT哈勒指数（CT-HI）。同期，采用EinScan-Pro 3D扫描仪进行胸壁扫描，并通过GeoMedic图像软件进行图像分析。在胸骨最凹点平面，皮肤最低点至背部皮肤的距离为前后径（A），在同一平面测量最大平面直径（B），B/A比值为三维哈勒指数（3D-HI）。采用Pearson相关分析分析两种测量方法的一致性。采用Kappa检验分析基于CT-HI和3D-HI截断值的手术指征的一致性。
所有患儿均能配合CT及3D胸壁表面扫描。CT-HI的平均值为3.82±0.96，3D-HI的平均值为1.82±0.23。Pearson相关分析显示，CT-HI与3D-HI的相关系数为0.823（<0.01）。当将CT-HI>3.2和3D-HI>1.7设定为手术指征的截断值时，3D-HI的敏感性和特异性分别为90.48%和100.0%。3D-HI与CT-HI在手术指征方面具有良好的一致性（Kappa=0.801）。
3D扫描可用于评估儿童漏斗胸，3D-HI>1.7可作为手术指征的截断值。
