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. 2016 Oct;229(4):577-81.
doi: 10.1111/joa.12499. Epub 2016 May 31.

The measurement of the normal thorax using the Haller index methodology at multiple vertebral levels

James E Archer  1 , Adrian Gardner  1 , Fiona Berryman  1 , Paul Pynsent  2
Affiliations

The measurement of the normal thorax using the Haller index methodology at multiple vertebral levels

James E Archer et al. J Anat. 2016 Oct.

Abstract

The Haller index is a ratio of thoracic width and height, measured from an axial CT image and used to describe the internal dimensions of the thoracic cage. Although the Haller index for a normal thorax has been established (Haller et al. 1987; Daunt et al. 2004), this is only at one undefined vertebral level in the thorax. What is not clear is how the Haller index describes the thorax at every vertebral level in the absence of sternal deformity, or how this is affected by age. This paper documents the shape of the thorax using the Haller index calculated from the thoracic width and height at all vertebral levels of the thorax between 8 and 18 years of age. The Haller Index changes with vertebral level, with the largest ratio seen in the most cranial levels of the thorax. Increasing age alters the shape of the thorax, with the most cranial vertebral levels having a greater Haller index over the mid thorax, which does not change. A slight increase is seen in the more caudal vertebral levels. These data highlight that a 'one size fits all' rule for chest width and depth ratio at all ages and all thoracic levels is not appropriate. The normal range for width to height ratio should be based on a patient's age and vertebral level.

Keywords: CT; Haller index; chest wall; paediatric; pectus excavatum; sternum; thoracic cage.

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Figures

Figure 1
Figure 1
An example of an axial CT image with the measurements required for calculation of the Haller index, the ratio of A/B.
Figure 2
Figure 2
The Haller index per level in males and females. The median value is shown as a horizontal line at the level of the pinch in the box. The mean and 95% confidence interval of the mean shown as the solid dot and whiskers around that dot in each box.
Figure 3
Figure 3
The thoracic width (A) per level in males and females.
Figure 4
Figure 4
The thoracic height (B) per level in males and females.
Figure 5
Figure 5
The Haller index against age per level in males.
Figure 6
Figure 6
The Haller index against age per level in females.
See this image and copyright information in PMC

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