Abstract
This cross-sectional study was carried out to investigate the role of arterial blood supply to the anterior chest wall in the pathogenesis of idiopathic scoliosis in adolescent females. Previous investigations have postulated that there is some asymmetry of the breasts in female adolescents with thoracic scoliosis that may be linked with anatomic and functional asymmetry of the internal mammary (IMA) artery that is the main supplier to the mammary gland. For this reason the present study investigated several anatomic and hemodynamic flow parameters of the IMA with color Doppler ultrasonography (CDU). Twenty female adolescents with right convex thoracic scoliosis were examined with roentgenograms to measure scoliosis curve, vertebral rotation, and concave and convex rib-vertebra angle at three vertebrae (apical, and one level above and one below the apical vertebra). Sixteen comparable nonscoliotic females were used as controls. CDU measured the IMA lumen diameter, its cross-sectional area, time average mean flow, and flow volume per minute. In scoliotics the obtained roentgenographic and ultrasonographic parameters were compared with each other to disclose any relationship. The reliability of CDU was high and the intraobserver variability low (ANOVA, P=0.92–0.94). There was no statistically significant difference in the ultrasonographic parameters of the IMA between right and left side in each individual or between scoliotics and controls. In scoliotics significant (P<0.05–0.01) correlations were shown between anatomic and hemodynamic parameters of internal mammary artery and juxta-apical convex and concave rib-vertebra angle. This study showed that the blood supply to the anterior chest wall in female adolescent scoliotics suffering from right-convex thoracic scoliosis is significantly correlated with juxta-apical convex and concave rib-vertebra angles. Thus, although this study found no correlation between scoliosis characteristics and anterior wall blood supply, it theoretically supports the hypothesis of a possible correlation between juxta-apical thorax asymmetry and anterior chest-wall blood supply in idiopathic scoliosis.
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