Services on Demand
Jornal de Pediatria
On-line version ISSN 1678-4782
RICIERI, Denise da V.; ROSARIO, Nelson A. and COSTA, Jecilene R.. Chest diameter ratios for detecting static hyperinflation in children using photogrammetry. J. Pediatr. (Rio J.) [online]. 2008, vol.84, n.5, pp. 410-415. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572008000600006.
OBJECTIVES: To develop a photogrammetric method capable of identifying increases in anteroposterior chest diameters suggestive of pulmonary hyperinflation, and to test it with both asthmatic and asthma-free children. METHODS: Two distinct study designs were used to achieve these two objectives. The first was a descriptive analysis of diameters measured at the height of the axilla and of the xiphoid on digital images of 56 children aged 8 to 12 years photographed in the orthostatic position. The second was a case-control study of (a) 19 asthmatic children in treatment for at least 12 months; and (b) 37 children free from asthma with no prior history of complaints of respiratory/allergic disease. Diameters were measured on images of the front and left side views using CorelDRAW®, and the ratio between the front and side diameters was calculated for the axillary and xiphoid measurements, providing the diameter ratios. Diameter ratios close to or greater than 1 represent geometry tending towards a cylindrical shape, typical of hyperinflation on radiographs. RESULTS: Analysis with the t test for independent samples revealed a mean diameter ratio at the sternum that was significantly greater in the group of asthmatic children (p < 0.01) than the mean for the whole sample and also than the mean for the children without asthma. CONCLUSIONS: Despite the existence of disagreement on the best instruments, methods and times for identifying hyperinflation, results indicate that a system using diameter ratios obtained by photogrammetry is a promising tool for the identification of a kinesiopathological manifestation that is known to determine air entrapment in asthma patients. Research that combines clinical data with longitudinal intrapatient follow-up will be necessary to establish the strength of the evidence found in this study.
Keywords : Hyperinflation; photogrammetry; asthma.