Kondo Satoshi, Takagi Daisuke, Osaga Satoshi, Okuda Katsuhiro, Nakanishi Ryoichi
Division of Pediatric Surgery, Nagoya City University Hospital, Kawasumi-1, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School, Kawasumi-1, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Pediatr Surg Int. 2020 Mar;36(3):305-316. doi: 10.1007/s00383-020-04622-2. Epub 2020 Jan 31.
Recently, several investigators reported that costal cartilage does not overgrow in pectus excavatum (PE). We wished to clarify whether costochondral length is longer in PE than the normal thorax and we tried to clarify the change of the shape of precordial concavity according to the growth in PE.
We evaluated 243 CT axial images of patients with PE and 246 CT axial images of patients without thoracic deformity. We divided the fifth costal cartilage into several lengths. We considered each part to be a straight line and calculated the length of the lines. We compared the approximate costochondral length between PE and normal thorax. We analyzed the distance between both anterior tips of fifth rib, and the ratio of the width and the depth of concavity to thoracic diameter in PE.
The costochondral length in patients with PE is highly likely to be longer than that of the normal thorax. The length of costal cartilage may be longer in asymmetric PE than symmetric PE. It may start in infantile period in PE that the thoracic shape turns into asymmetry from symmetry. The precordial concavity of PE may be shaped by overgrowth of both costal cartilages and ribs.
最近，一些研究者报道漏斗胸（PE）患者的肋软骨不会过度生长。我们希望阐明PE患者的肋软骨长度是否比正常胸廓更长，并试图阐明PE患者心前区凹陷形状随生长的变化情况。
我们评估了243例PE患者的CT轴位图像和246例无胸廓畸形患者的CT轴位图像。我们将第五肋软骨分成几段长度。我们将每一部分视为一条直线并计算这些直线的长度。我们比较了PE患者与正常胸廓患者的肋软骨近似长度。我们分析了第五肋两端前侧尖端之间的距离，以及PE患者凹陷宽度与深度和胸廓直径的比值。
PE患者的肋软骨长度极有可能比正常胸廓的更长。不对称PE患者的肋软骨长度可能比对称PE患者的更长。在PE患者中，胸廓形状可能在婴儿期就开始从对称转变为不对称。PE的心前区凹陷可能是由肋软骨和肋骨的过度生长形成的。
