Department of Radiology, Montefiore Medical Center, 111 E. 210th St., Bronx, NY, 10467, USA.
Pediatr Radiol. 2021 Aug;51(9):1676-1681. doi: 10.1007/s00247-021-05026-7. Epub 2021 Mar 19.
While congenital heart disease (CHD) is known to be associated with sternal abnormalities, its association with absent sternal ossification is less well known. The literature is sparse and based on radiographs.
To quantify delayed sternal ossification in CHD using computed tomography (CT).
An imaging database search identified children with complex CHD and controls younger than 3 years of age who underwent chest CT from 2010 to 2019. Records were reviewed for demographics, CHD type and other pertinent history. Images were reviewed for manubrial or sternal segment ossification. Controls consisted of children undergoing chest CT for noncardiac reasons. Statistical analyses were conducted using a significance threshold of 0.05.
Fifty-nine children had complex CHD (mean age: 9.4 months); 36 (61.0%) had cyanotic CHD. There were 189 controls (mean age: 17.9 months). Delayed sternal ossification was present in 7 children (11.9%) in the study group; 6 had cyanotic heart disease (85.7%). Patterns of ossification included manubrium only; manubrium and first sternal segment; first and second sternal segments; and manubrium, first segment and hypoplastic second segment. Three controls (1.6%) had sternal ossification delay, all with manubrial ossification only. Delayed sternal ossification was more prevalent in the study group than in the controls (P=0.002). Compared to the controls, a higher incidence of delayed sternal ossification was seen in children with cyanotic CHD (P<0.001) but not acyanotic CHD (P=0.37).
Delayed sternal ossification occurs in children with CHD, particularly cyanotic forms, and requires no additional work-up.
虽然先天性心脏病（CHD）与胸骨异常有关，但胸骨骨化不全与 CHD 的关系鲜为人知。目前文献很少且基于放射学检查。
使用计算机断层扫描（CT）定量 CHD 患者胸骨骨化延迟。
通过影像学数据库检索，确定了 2010 年至 2019 年期间因复杂 CHD 且年龄小于 3 岁行胸部 CT 检查的患儿以及因非心脏原因行胸部 CT 检查的对照组患儿。回顾记录患者的人口统计学、CHD 类型和其他相关病史。评估胸骨柄或胸骨节段骨化情况。对照组为因非心脏原因行胸部 CT 检查的患儿。采用 0.05 的显著性水平进行统计学分析。
59 例患儿患有复杂 CHD（平均年龄：9.4 个月）；36 例（61.0%）患儿患有紫绀型 CHD。研究组中共有 7 例（11.9%）患儿存在胸骨骨化延迟，其中 6 例（85.7%）患儿患有紫绀型心脏病。骨化模式包括仅胸骨柄、胸骨柄和第一胸骨段、第一和第二胸骨段以及胸骨柄、第一胸骨段和发育不良的第二胸骨段。对照组中有 3 例（1.6%）患儿存在胸骨骨化延迟，均为仅胸骨柄骨化。与对照组相比，CHD 患儿胸骨骨化延迟的发生率更高（P=0.002）。与对照组相比，紫绀型 CHD 患儿胸骨骨化延迟的发生率更高（P<0.001），而非紫绀型 CHD 患儿胸骨骨化延迟的发生率无显著差异（P=0.37）。
CHD 患儿，尤其是紫绀型 CHD 患儿，会出现胸骨骨化延迟，无需进一步检查。
