J Korean Soc Radiol.  2011 Sep;65(3):289-295.

Scoliotic Change in Patients Having Undergone a Mastectomy: Analysis Using Multi-Detector Computed Tomography

• Kim MS
• Kim HW
• Juhng SK
• Choi SS

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 4.4degrees +/- 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.

MeSH Terms

Breast
Female
Humans
Image Processing, Computer-Assisted
Mastectomy
Surveys and Questionnaires
Scoliosis
Shoulder
Spine
Thoracic Wall
Thorax
Tomography, Spiral Computed

Figure

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  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.

• 

  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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