Radiographic assessment of the cardiothoracic ratio in the pediatric age group at a tertiary institution in North-Central Nigeria

Abstract

Objectives: The most common method for detecting cardiomegaly and calculating the cardiothoracic ratio (CTR) is through the use of chest radiography. Since 1919, when the CTR was first described, there has been an interest in its utility as a predicator of heart size, leading to a lot of research, notably in the adult Caucasian population. However, in the African pediatric age group, there is paucity of data on this subject. We aim to establish normative data on CTR and its determinants in Nigerian children aged 1–15 years, using chest radiographs. Material and Methods: This was a 7-month observational analytical study assessing chest radiographs of healthy children aged 1–15 years at the Radiology Department of Benue State University Teaching Hospital, Makurdi, from May to November 2021. The respondents’ biometrics and chest radiographs were obtained after the protocol was authorized by the institutional Health Research Ethics Committee. The CTR was calculated using measurements of the maximum transverse cardiac diameter (MTCD) and the maximum internal thoracic width (MITW). The data obtained were analyzed using Statistical Package for the Social Sciences version 26, and Microsoft Excel 2017. The statistical significance level was selected at P ≤ 0.05. Results: A total of 150 pediatric chest radiographs were evaluated, with a male: female ratio of 1.4:1. The study population’s mean age was 6.9 ± 4.8 years. There was a steady decrease in CTR with increasing age across the sexes. The mean CTR of the general population was 49.3%. Weight, height, age, and MITW correlated negatively but statistically significantly with CTR (P = 0.000), while the correlation of CTR with race, MTCD, and sex was not statistically significant (P = 0.657, 0.688, and 0.692, consecutively). Conclusion: The result of the study has established 49.3% as the mean CTR value of the pediatric age group in our environment. We also found out that CTR was significantly influenced by weight, height, age, and thoracic size (MITW).