{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T09:40:22Z","timestamp":1700646022485},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"European Society for Pediatric Radiology","award":["Guy Sebag Grant 2019"]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>The breathing phase for the determination of thoracic indices in patients with pectus excavatum is not standardized. The aim of this study was to identify the best period for reliable assessments of morphologic indices by dynamic observations of the chest wall using real-time MRI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this prospective study, patients with pectus excavatum underwent morphologic evaluation by real-time MRI at 3 T between January 2020 and June 2021. The Haller index (HI), correction index (CI), modified asymmetry index (AI), and modified eccentricity index (EI) were determined during free, quiet, and forced breathing respectively. Breathing-related differences in the thoracic indices were analyzed with the Wilcoxon signed-rank test. Motion of the anterior chest wall was analyzed as well.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 56 patients (11 females and 45 males, median age 15.4 years, interquartile range 14.3\u201316.9) were included. In quiet expiration, the median HI in the cohort equaled 5.7 (4.5\u20137.2). The median absolute differences (\u0394) in the thoracic indices between peak inspiration and peak expiration were \u0394HI = 1.1 (0.7\u20131.6, <jats:italic>p<\/jats:italic> &lt; .001), \u0394CI = 4.8% (1.3\u20137.5%, <jats:italic>p<\/jats:italic> &lt; .001), \u0394AI = 3.0% (1.0\u20135.0%, <jats:italic>p<\/jats:italic> &lt; .001), and \u0394EI = 8.0% (3.0\u201314.0%, <jats:italic>p<\/jats:italic> &lt; .05). The indices varied significantly during different inspiratory phases, but not during expiration (<jats:italic>p<\/jats:italic> &gt; .05 each). Furthermore, the dynamic evaluation revealed three distinctive movement patterns of the funnel chest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Real-time MRI reveals patterns of chest wall motion and indicate that thoracic indices of pectus excavatum should be assessed in the end-expiratory phase of quiet expiration.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 The thoracic indices in patients with pectus excavatum depend on the breathing phase.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Quiet expiration represents the best breathing phase for determining thoracic indices.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Real-time MRI can identify different chest wall motion patterns in pectus excavatum.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-022-09197-1","type":"journal-article","created":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T03:20:19Z","timestamp":1667013619000},"page":"2128-2135","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pectus excavatum in motion: dynamic evaluation using real-time MRI"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"http:\/\/orcid.org\/0000-0002-7680-0990","authenticated-orcid":false,"given":"Daniel","family":"Gr\u00e4fe","sequence":"first","affiliation":[]},{"given":"Martin","family":"Lacher","sequence":"additional","affiliation":[]},{"given":"Illya","family":"Martynov","sequence":"additional","affiliation":[]},{"given":"Franz Wolfgang","family":"Hirsch","sequence":"additional","affiliation":[]},{"given":"Dirk","family":"Voit","sequence":"additional","affiliation":[]},{"given":"Jens","family":"Frahm","sequence":"additional","affiliation":[]},{"given":"Harald","family":"Busse","sequence":"additional","affiliation":[]},{"given":"Sergio Bruno","family":"Sesia","sequence":"additional","affiliation":[]},{"given":"Sebastian","family":"Kr\u00e4mer","sequence":"additional","affiliation":[]},{"given":"Peter","family":"Zimmermann","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,10,29]]},"reference":[{"key":"9197_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1053\/j.semtcvs.2009.03.001","volume":"21","author":"AA Fokin","year":"2009","unstructured":"Fokin AA, Steuerwald NM, Ahrens WA, Allen KE (2009) Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. 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The other authors declare no competing interests","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 prospective\u2022 cross-sectional study\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}