Breath-hold MRI in evaluating patients with pectus excavatum

Area of Science:

• Radiology
• Medical Imaging
• Thoracic Surgery

Background:

• Pectus excavatum (PE) is a congenital chest wall deformity with uncertain etiology.
• Diaphragmatic abnormalities are suspected contributors to PE.
• Limited data exists on using fast MRI for PE evaluation.

Purpose of the Study:

• To assess static and dynamic chest wall characteristics in PE using fast MRI.
• To evaluate cardiac displacement and diaphragmatic excursion in PE patients.
• To determine the utility of fast MRI in characterizing PE.

Main Methods:

• Fast MRI sequences (FLASH, TurboFLASH) were used in axial and coronal planes.
• Six young PE patients and six healthy controls were scanned during inspiratory and expiratory breath-holds.
• Pectus Index, cardiac distances, and diaphragmatic excursion were measured.

Main Results:

• Sternal depression significantly worsened during expiration in PE patients.
• PE patients exhibited significantly flatter chests compared to controls.
• A trend towards leftward cardiac displacement and altered diaphragmatic excursion was observed in PE patients.

Conclusions:

• Fast MRI is highly informative for evaluating skeletal abnormalities in PE.
• Fast MRI effectively visualizes chest wall motion, cardiac, and diaphragmatic changes in PE.
• This technique aids in the comprehensive assessment of pectus excavatum.