Journal List > J Korean Soc Radiol > v.65(3) > 1087005

Kim, Kim, Juhng, and Choi: Scoliotic Change in Patients Having Undergone a Mastectomy: Analysis Using Multi-Detector Computed Tomography

Abstract

Purpose

To evaluate the relationship between the degree of scoliotic curvature and postoperative change of the chest wall among patients who underwent a unilateral mastectomy.

Materials and Methods

Subjects were comprised of 56 women who underwent chest CT and a whole spine standing anteroposterior view (WSSAP). Cobb's angle and each side of the chest wall volume, including the breast, were measured with the WSSAP and a 3-D reconstructed multi-detector computed tomography (MDCT) image. A correlation analysis was performed between the scoliotic curvature and chest wall volume asymmetry. Directional correspondence between development of scoliosis and undergoing a mastectomy was analyzed. Furthermore, a survey on patient shoulder function was performed using a questionnaire and a correlation was performed between the results of the survey and the scoliotic curvature and chest wall volume asymmetry.

Results

The findings indicate that Cobb's angles were 4.4° ± 2.7 (Mean ± SD, range from 0.6 to 11.4). Differences in chest wall volume were 474.64 ± 276.36 cm3 (Mean ± SD, range from 78 to 1379). No statistical significance was noted between the degree of scoliotic curvature and chest wall volume asymmetry (p > 0.05). A cross-tabulation analysis of the direction between the scoliotic curvature and mastectomy was found to be statistically significant (p < 0.001). Also, there was a significant correlation between shoulder function assessment score and the degree of scoliotic curvature (p = 0.003), while no significant correlation between shoulder function assessment score and chest wall volume asymmetry (p = 0.091) could be found.

Conclusion

Scoliotic change had a tendency to be on the opposite side of the mastectomy and had no statistically significant relationship with the volume asymmetry. Thus, 3-D reconstructed MDCT images are helpful in differentiating selective volume differences.

Figures and Tables

Fig. 1

Measuring Cobb's angle by Cobb method of 44 years old female patient.

A. Preoperative chest plane radiograph.
B. Whole spine standing anteroposterior view after 4 years.
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Fig. 2

Measured volume of the chest wall by 3D reconstructed volume rendering image of chest MDCT.

A. Whole chest wall volume is divided into 4 segments by right anterior (RtA), left anterior (LtA), right posterior (RtP), left posterior (LtP).
B. The muscle volume of chest wall is measured with 20-80 HU threshold (mRtA, mLtA, mRtP, mLtP).
Note.-MDCT = multi-detector computed tomography
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Table 1

Assessment of Shoulder Function

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Note.-*Questions were designed on a 5-point scale of difficulty from 0 (no difficulty) to 4 (inability to perform the task).

Table 2

Chest Wall Volume Differences in Mastectomy Patients by Chest MDCT with 3D Volume Reconstruction

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Note.-RtA and LtA = right and left anterior chest wall volume,

mRtP and mLtP = right and left posterior chest wall muscular volume

Table 3

Direction of Scoliotic Change According to Mastectomy Site

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Note.-Chi-square test = statistical significant difference (p-value < 0.001)

Table 4

Correlation Analysis of Volume Differences and Scoliotic Curvature

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Note.-*> 0 = in Left sided scoliotic change, < 0 = in Right sided scoliotic change

Notes

This paper was supported by Wonkwang University in 2010.

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