Cardiothoracic Index
(made on upright frontal view of chest at 72 inches during quiet breathing)

(re-drawn from Caffey J.  Pediatric X-ray Diagnosis.  7th Ed. 1978, p 543)

ID = internal diameter of chest at level of right hemidiaphragm
MRD = greatest perpendicular diameter from midline to right heart border
MLD = greatest perpendicular diameter from midline to left heart border

CT index = (MRD + MLD)/ID


 
 
Age Mean CT index Standard Deviation X 1 Range
0-3 weeks1 0.55 0.05 0.65-0.45
4-7 weeks1 0.58 0.06 0.70-0.46
1 year1 0.53 0.04 0.61-0.45
1-2 years2 0.49   0.60-0.39
2-6 years2 0.45   0.52-0.40
> 7 years3 <0.50   0.50-0.40

Comments:

1st year of life, larger CT index due to more transverse heart position in chest compared to older children and adults, and from data derived from films obtained in expiratory phase of respiration.
Data in infants and young children obtained from supine films at 1.5m distance

1.  Bakwin H, Bakwin R.  Body build in infants:  VI.  Growth of the cardiac silhouette and the thoraco-abdominal cavity.  Am J Dis Child. 49:861, 1935
2.  Maresh MM, Washburn AH.  Size of the heart in healthy children.  Am J Dis Child 56:33, 1938
3.  Lincoln EM, Spillman R.  Studies of the hearts of normal children:  II.  Roentgen ray studies.  Am J Dis Child 35:791, 1928.

 

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