Tuberc Respir Dis.  2018 Apr;81(2):123-131. 10.4046/trd.2017.0095.

Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease

Affiliations
  • 1Department of Internal Medicine, Masan Medical Center, Masan, Korea.
  • 2Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea. hockkim@gnu.ac.kr
  • 3Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 4Department of Diagnostic Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
  • 5Department of Preventive Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.

Abstract

BACKGROUND
Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD.
METHODS
We enrolled 85 patients with COPD (76 males, 9 females; mean age, 70.6±7.1 years) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax.
RESULTS
The average AP diameter was significantly greater in patients with COPD compared with normal controls (13.1±2.8 cm vs. 12.2±1.13 cm, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls (0.66±0.061 vs. 0.61±0.86; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=−0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001).
CONCLUSION
Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.

Keyword

Pulmonary Disease, Chronic Obstructive; Rib Cage; Tomography, X-Ray Computed

MeSH Terms

Body Mass Index
Female
Humans
Lung
Male
Pulmonary Disease, Chronic Obstructive*
Spine
Thorax
Tomography, X-Ray Computed

Figure

  • Figure 1 Example illustrating the thoracic cage dimensions. A, the maximal transverse diameter (from the most external midpoint of the rib of one side to the opposite one); B, mid-sagittal anteroposterior diameter (from the inner surface of the sternum to ventral surface of the vertebral body); C and D, the maximal anteroposterior diameters of the right and left hemithorax (from the ventral-most point to the dorsal-most point of the rib cage in each hemithorax).


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