Pectus Excavatum: Comparing Magnetic Resonance Imaging to Computed Tomography

Nomrota Majumder ‘21

Figure 1: Comparison of MRI and CT methods show MRI to be more safe although just as effective in recording preoperative measures in children with Pectus Excavatum.

Pectus Excavatum (PE) is a structural deformity of the anterior thoracic wall, located along the thoracic artery, and causes the breastbone to essentially sink into the chest. As the most common thoracic wall deformity in children, this condition is often congenital and worsens during the adolescent growth years. In addition to the phenotypic difference associated with this connective tissue disease, other symptoms include chest pain, fatigue, palpitations, coughing, and shortness of breath. Although treatment of PE usually involves physical therapy to alleviate the symptoms, surgery is sometimes necessary in cases in which PE affects the cardiovascular system as well as the respiratory system. As a result, scientists from Beijing’s Children’s Hospital were curious if Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) is the better suited system to measure preoperative parameters of children with PE. 

The study was conducted on children who were hospitalized at the Department of Thoracic Surgery of the Heart at Beijing’s Children’s Hospital from June 2014 to June 2015. The methodology involved recording mDIXON MRI sequences in inspiratory and expiratory phases of breathing, which allows thoracic parameters to be measured including morphology and pulmonary function. The mDIXON technique was used in conjunction with 3DTI, which allows for chest scanning during free breathing, providing a full picture in real-time. The main quantification method was thoracic volume, or the rough residual capacity of the lung. Chest CT was first administered in these hospitalized PE children, followed by MRI three days after. The results showed insignificant differences in lung volume recorded from MRI and CT. Other cardiac, lung, and retrosternal (behind the breastbone) parameters were highly correlated between the two as well. The researchers concluded that although each imaging technique yielded almost identical results, patients would benefit from mDIXON MRI in combination with held respiration as opposed to CT since the issue of potentially harmful radiation would be avoided. 

Both MRI and CT are popular imaging methods in almost every medical facility worldwide, but when used frequently in a disorder as in PE, it’s crucial to minimize external risks and maximize the best path to obtaining solid preoperative measures.



  1. J. Sun, et. al., Comparison of magnetic resonance imaging and computed tomography to measure preoperative parameters of children with pectus excavatum. Pediatric Investigation, (2019).
  2. Image retrieved from:

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