Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
Eur J Cardiothorac Surg. 2024 May 3;65(5). doi: 10.1093/ejcts/ezae143.
The Haller index (HI) is widely utilized as a quantitative indicator to assess the extent of the pectus excavatum (PE) deformity, which is the most common chest wall abnormality in children. Both preoperative correction planning and postoperative follow-up need to be based on the standard of normal thoracic growth and development. However, there is currently no established reference range for the HI in children. Consequently, the goal of this study was to conduct a preliminary investigation of normal HI values among children to understand thoracic developmental characteristics.
Chest computed tomography images obtained from January 2012 to March 2022 were randomly selected from the imaging system of the Children's Hospital of Chongqing Medical University. We divided the images of children into a total of 19 groups: aged 0-3 months (1 group), 4-12 months (1 group) and 1 year to 17 years (17 groups), with 50 males and 50 females, totaling 100 children in each group. HI was measured in the plane where the lowest point of the anterior thoracic wall was located and statistically analysed using SPSS 26.0 software.
A total of 1900 patients were included in the study. Our results showed that HI, transverse diameter and anterior-posterior diameter were positively correlated with age (P < 0.05). Using age as the independent variable and HI as the dependent variable, the best-fit regression equations were HI-male = 2.047 * Age0.054(R2 = 0.276, P<0.0001) and HI-female = 2.045 * Age0.067(R2 = 0.398, P<0.0001). Males had significantly larger thoracic diameters than females, and there was little difference in the HI between the 2 sexes.
The HI rapidly increases during the neonatal period, slowly increases during infancy and stops increasing during puberty, with no significant differences between the sexes.
Haller 指数（HI）被广泛用作评估漏斗胸（PE）畸形严重程度的定量指标，这是儿童中最常见的胸廓异常。术前矫正规划和术后随访都需要基于正常的胸廓生长发育标准。然而，目前儿童的 HI 尚无既定的参考范围。因此，本研究旨在初步探讨儿童正常 HI 值，以了解胸廓发育特征。
从重庆医科大学儿童医院影像系统中随机抽取 2012 年 1 月至 2022 年 3 月期间的胸部 CT 图像。将儿童的图像分为共 19 组：0-3 个月龄（1 组）、4-12 个月龄（1 组）和 1 岁至 17 岁（17 组），每组男女各 50 名，共计 100 名儿童。在最低前胸壁平面测量 HI，并使用 SPSS 26.0 软件进行统计学分析。
本研究共纳入 1900 例患者。结果显示，HI、横径和前后径与年龄呈正相关（P<0.05）。以年龄为自变量，HI 为因变量，最佳拟合回归方程为 HI-男性=2.047Age0.054（R2=0.276，P<0.0001）和 HI-女性=2.045Age0.067（R2=0.398，P<0.0001）。男性的胸廓直径明显大于女性，而两性间 HI 差异不大。
HI 在新生儿期迅速增加，在婴儿期缓慢增加，在青春期停止增加，两性间无显著差异。
