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目的 评价漏斗胸畸形的螺旋CT表现及胸骨凹陷对心脏形态和位置等的影响。方法 搜集 1999～ 2 0 0 3年行螺旋CT检查并经手术治疗的漏斗胸 32例。在CT图像上 ,观察和测定漏斗胸的胸骨凹陷深度、CT凹陷指数 [左胸矢状内径 (b)与胸椎体前缘至胸骨后缘距离 (a)的比值 ]、心脏旋转角度 (胸椎体前缘至心尖连线与胸矢状线的夹角 )和左下肺静脉干轴线与胸矢状线的夹角 (PV角 ) ,评价它们之间的关系。结果 32例漏斗胸显示了不同程度的胸骨凹陷 ,平均凹陷深度为 (2 1± 7)mm ,CT凹陷指数 (b/a )为 2 9± 1 8,心脏旋转角为 (5 5 9± 9 8)° ,静脉角为 (49 8± 14 0 )°。胸骨轻度畸形 11例 (b/a <2 4 )、中度 12例 (b/a =2 4～ 2 9)、重度 9例 (b/a >2 9) ,胸骨平均凹陷深度分别为17、2 1、2 7mm ,三者间差异有非常显著性意义 (F =5 39,P <0 0 1) ;心脏旋转角分别为 4 9 7°、5 5 5°和6 6 9° ,三者间差异有非常显著性意义 (F =7 4 4 ,P <0 0 1) ;而PV角分别为 5 8 7°、4 6 5°和 4 2 4° ,三者间差异也有显著性意义 (F =3 33,P <0 0 5 )。随着CT凹陷指数的增加 ,心脏旋转角度也增大 ,两者的相关系数为 0 73(P <0 0 1)。结论 螺旋CT扫描可准确显示漏斗胸的胸骨畸形
Objective To evaluate the CT findings of funnel thoracic deformities and the effect of sternum depressions on the morphology and location of the heart. Methods Thirty-two cases of funnel chest collected by spiral CT in 1999 ~ 2003 were collected. On the CT image, the depth of the sternum in the funnel chest was observed and measured. The CT sagittal index (ratio of the left sagittal sagittal diameter (b) to the distance from the anterior edge of the thoracic vertebral body to the sternum of the sternum (a)], the heart rotation angle The angle between the anterior vertebral edge and the apex of the apex and the sagittal stenosis) and the angle (PV angle) between the trunk axis of the left lower pulmonary vein and the sagittal plane of the thoracic vein were measured to evaluate the relationship between them. Results 32 cases of funnel chest showed different degrees of sternum depression, the average depth of depression was (2 1 ± 7) mm, CT depression index (b / a) was 29 ± 18 and heart rotation angle was (559 ± 9) 8) °, venous angle (49 8 ± 14 0) °. 11 cases had mild sternal deformity (b / a <2 4), 12 moderate (b / a = 24-29) and 9 severe (b / a> 2 9) , Respectively. There was a significant difference between the three groups (F = 5 39, P 0 01). The heart rotation angles were 497 °, 555 ° and 669 ° respectively. There was a significant difference between the two groups (F = 74.4, P <0.01), while the PV angles were 58.7 °, 46.5 ° and 42.4 °, respectively, with significant differences (F = 33 3, P <0 05). As the CT sag index increased, the heart rotation angle also increased, with a correlation coefficient of 0 73 (P <0.01). Conclusion Spiral CT scan can accurately show the sternum of the funnel chest