A CLINICO-ANATOMICAL EVALUATION OF THORACIC CAGE DIMENSIONS AT MULTIPLE VERTEBRAL LEVELS IN HEALTHY INDIVIDUALS AND PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE USING COMPUTED TOMOGRAPHY OF THE THORAX
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Keywords
COPD, Haller’s Index, CT, GOLD stage.
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with progressive structural alterations of the lungs and thoracic cage due to chronic hyperinflation and parenchymal destruction. These changes modify chest wall geometry, adversely affecting respiratory mechanics. Computed tomography (CT) allows precise assessment of thoracic cage dimensions, yet vertebral-level–wise morphometric evaluation in COPD remains limited.
Methods: This prospective observational study included 90 adult subjects (45 COPD patients and 45 healthy controls) who underwent high-resolution computed tomography (HRCT) of the thorax. Thoracic cage measurements were performed at thoracic vertebral levels T3–T12, including maximum transverse diameter and minimum anteroposterior diameter. Haller’s Index (HI) was calculated at each level. COPD patients were further categorized into emphysema-predominant and chronic bronchitis–predominant phenotypes and staged according to GOLD criteria. Morphometric parameters were compared between groups and correlated with disease phenotype and severity.
Results: Emphysema-predominant COPD was the most common phenotype (57.8%). Compared to chronic bronchitis–predominant patients, emphysema patients demonstrated significantly higher mean transverse diameter (271.8 ± 22.3 mm vs 254.6 ± 18.9 mm), reduced anteroposterior diameter (75.9 ± 7.1 mm vs 82.4 ± 7.6 mm), and elevated Haller’s Index (3.52 ± 0.39 vs 3.09 ± 0.28; p < 0.001). Haller’s Index showed significant positive correlations with bronchial wall thickness and chronic bronchitis severity. Progressive increases in transverse diameter and HI were observed with advancing GOLD stage. Vertebral-level analysis revealed a gradual increase in HI from upper to lower thoracic levels.
Conclusion: Vertebral-level–wise CT assessment demonstrates significant thoracic cage remodeling in COPD, particularly in emphysema-predominant disease, and correlates with disease severity. Haller’s Index serves as a useful quantitative marker of thoracic structural alteration in COPD.
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Dinesh Kumar Jayraj
PhD Scholar, Department of Anatomy, Index Medical College, Hospital & Research Centre, Indore, (M.P) India (Malwanchal University) Email – [email protected]
Dr Rajendra Singh
Assistant professor, Department of Anatomy, Index Medical College, Hospital & Research Centre, Indore (M.P)India. (Malwanchal University) Email- [email protected]
Dr. Pawan kumar Mahato
Assistant Professor Department of Anatomy Index Medical College, Hospital & Research Centre, Indore (M.P)India. (Malwanchal University)
