Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2024 Jul 23;19(7):e0299589. doi: 10.1371/journal.pone.0299589. eCollection 2024.
The purpose of this study was to evaluate the quantitative computed tomography (CT) volumetry and densitometry and in pediatric patients with pectus excavatum (PE). We measured pectus index (PI) and separated inspiratory and expiratory lung volumes and densities. We obtained the total lung volume (TLV) and mean lung density (MLD) during inspiration and expiration, and the ratio of end expiratory to inspiratory volume (E/I volume) and MLD (E/I density) were calculated. The difference between inspiratory and end expiratory volume (I-E volume) and MLD (I-E density) were also calculated. A total of 199 patients, including 164 PE patients and 35 controls, were included in this study. The result shows that the PE group had lower inspiratory TLV (mean, 2670.76±1364.22 ml) than the control group (3219.57±1313.87 ml; p = 0.027). In the PE group, the inspiratory (-787.21±52.27 HU vs. -804.94±63.3 HU) and expiratory MLD (-704.51±55.41 HU vs. -675.83±64.62 HU) were significantly lower than the indices obtained from the control group (p = 0.006). In addition, significantly lower values of TLV and MLD difference and higher value of TLV and MLD ratio were found in the PE group (p <0.0001). PE patients were divided into severe vs. mild groups based on the PI cutoff value of 3.5. The inspiratory MLD and TLV ratio in the severe PE group were lower than those in the mild PE group, respectively (p <0.05). In conclusion, quantitative pulmonary evaluation through CT in pediatric PE patients may provide further information in assessing the functional changes in lung parenchyma as a result of chest wall deformity.
本研究旨在评估定量计算机断层扫描（CT）容积和密度，并评估患有漏斗胸（PE）的儿科患者。我们测量了胸壁指数（PI），并分别测量吸气和呼气肺容积和密度。我们在吸气和呼气时获得了总肺容积（TLV）和平均肺密度（MLD），并计算了呼气末与吸气末容积比（E/I 容积）和 MLD（E/I 密度）。我们还计算了吸气末与呼气末容积（I-E 容积）和 MLD（I-E 密度）之间的差异。本研究共纳入 199 名患者，包括 164 名 PE 患者和 35 名对照者。结果显示，PE 组吸气 TLV（平均值，2670.76±1364.22 ml）低于对照组（3219.57±1313.87 ml；p=0.027）。在 PE 组中，吸气时（-787.21±52.27 HU 比-804.94±63.3 HU）和呼气时的 MLD（-704.51±55.41 HU 比-675.83±64.62 HU）明显低于对照组（p=0.006）。此外，PE 组的 TLV 和 MLD 差值明显降低，TLV 和 MLD 比值明显升高（p<0.0001）。根据 3.5 的 PI 截断值，将 PE 患者分为严重组和轻度组。严重 PE 组的吸气 MLD 和 TLV 比值低于轻度 PE 组（p<0.05）。总之，CT 对小儿 PE 患者的肺部定量评估可提供胸廓畸形导致肺实质功能变化的进一步信息。
