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目的探讨Haller指数和心脏旋转角对漏斗胸的应用价值。方法对我院2004-03—2005-07间经手术治疗的35例患漏斗胸的患儿胸部CT检查进行回顾性的分析。Haller指数的计算方法为胸部最大内横径与同层面最小前后深度的比值。心脏旋转角的测量方法为:胸椎椎体前缘至心尖连线及其与胸矢状线的夹角。在CT图像上测定漏斗胸患者于手术前、手术后及正常对照组之间的Haller指数及心脏旋转角,并对测量数据进行统计学分析。结果35例漏斗胸患者均显示有不同程度的胸骨凹陷。手术前测量的Haller指数为5.4±1.8,手术后为3.1±1.6,两者间差异有非常显著性意义(t=7.34,P<0.01)。手术前心脏旋转角为67.8°±10.8°,手术后为62.1°±9.3°,两者间有显著性差异(t=2.42,P<0.05)。正常对照组的Haller指数为2.4±0.3,心脏旋转角为49.4°±2.5°。Haller指数增加,心脏旋转角也增大,两者间呈正相关,其相关系数为0.82(P<0.01)。4例术前CT检查提示有肺部病变,7例术后CT检查显示有肺实变。结论Haller指数和心脏旋转角是评价儿童漏斗胸的2个重要指标。
Objective To investigate the application value of Haller index and heart rotation angle on funnel chest. Methods A retrospective analysis of chest CT in 35 cases with funnel chest operated in our hospital from March 2004 to March 2005 was performed retrospectively. The Haller index is calculated as the ratio of the maximum internal transverse diameter of the chest to the minimum front-back depth of the same level. Heart rotation angle measurement method: thoracic vertebral anterior edge to the apex and its connection with the thoracic sagittal line angle. Haller index and heart rotation angle were measured on CT images before and after surgery and normal control group, and the measurement data were statistically analyzed. Results 35 cases of funnel chest patients showed varying degrees of sternum depression. The Haller index was 5.4 ± 1.8 before surgery and 3.1 ± 1.6 after surgery. There was a significant difference between the two groups (t = 7.34, P <0.01). The heart rotation angle before surgery was 67.8 ° ± 10.8 ° and 62.1 ° ± 9.3 ° after surgery. There was a significant difference between the two groups (t = 2.42, P <0.05). The Haller index of the normal control group was 2.4 ± 0.3, and the heart rotation angle was 49.4 ° ± 2.5 °. Haller index increased, heart rotation angle also increased, the two were positively correlated, the correlation coefficient was 0.82 (P <0.01). 4 cases of preoperative CT examination showed lung disease, 7 cases of postoperative CT examination showed lung consolidation. Conclusions The Haller index and heart rotation angle are two important indexes for evaluating funnel chest in children.