MORPHOLOGICAL CHARACTERISTICS AND CALCIFICATION DEGREES OF THE 4th TO 8th COSTAL CARTILAGES ON NON-CONTRAST COMPUTED TOMOGRAPHY

Nguyen Van Phung1, Nguyen Hoang Nhan1, Vo Nguyen Thanh Nhan2, Ngo Nguyen Tuong Vi1, Truong Ngco Thao1, Dinh Thi Huynh Nhi1
1 School of Medicine and Pharmacy, Tra Vinh University
2 Medic Medical Center Ho Chi Minh city

Main Article Content

Abstract

Objective: To evaluate the morphological characteristics and degree of calcification of the 4th to 8th costal cartilages on non-contrast CT scans images.


Materials and methods: A cross-sectional descriptive study with comparative analysis was conducted on 103 patients who underwent non-contrast CT scans including the costal cartilage region at Medic Medical Center, Ho Chi Minh City, from December 2025 to February 2026.


Results: Among 103 patients, corresponding to 1030 costal cartilages examined, females accounted for the majority (69.9%), with a mean age of 31.5 ± 8.3 years. The prevalence of costal cartilage calcification was 51.9%. Peripheral calcification was the predominant pattern (20.4-38.8%), while central calcification was the least common. Most costal cartilages showed no calcification or only mild calcification (grade 0 and grade 1 accounted for 89.1%). Both the prevalence and severity of calcification increased proportionally with age, with the highest frequency observed in the 44-56 age group. The 4th and 5th costal cartilages demonstrated the most pronounced changes over time.


Conclusion: Chest CT scans help accurately determine the morphological characteristics and degree of costal cartilage calcification, allowing for personalized selection of the optimal location and timing for costal cartilage harvesting for each patient.

Article Details

References

[1] Dam V.S, Berzenji D, Berg A.S et al. Costal cartilage calcification in a caucasian population: machine learning recommendations for chest CT-guided rhinoplasty planning. Facial Plast Surg, 2025, 1: 1-6. doi: 10.1055/a-2731-5948
[2] Elgendy M.M, Madkour S.A et al. Utility of the morphological scoring of costal cartilage ossification in age estimation of adult Egyptians using multidetector computed tomography. Forensic Sciences Research, 2025, 10 (2): 1-10. doi: 10.1093/fsr/owae061.
[3] Faderani R, Hall L.M, Saad A, Malhotra A. Preoperative imaging of costal cartilage to aid reconstructive head and neck surgery: a systematic review. European Archives of Oto-Rhino-Laryngology, 2022, 279 (12): 5673-5682. doi: 10.1007/s00405-022-07443-9.
[4] Hawellek T, Beil F.T, Hischke S, et al. Costal cartilage calcification: prevalence, amount, and structural pattern in the general population and its association with age: a cadaveric study. Facial Plast Surg Aesthet Med, 2024, 26 (04): 481-487. doi: 10.1089/fpsam.2021.0063.
[5] Meng X, Wu Y, Wang X et al. Analysis of tissue volume and calcification of the 6th to 8th costal cartilage in 70 woman patients. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2022, 75, 2727-2734. doi: 10.1016/j.bjps.2022.02.033.
[6] Sunwoo W.S, Choi H.G, Kim D.W et al. Characteristics of rib cartilage calcification in Asian patients. JAMA Facial Plastic Surgery, 2014, 16 (2): 102-106. doi: 10.1001/jamafacial.2013.2031.
[7] Szychta P. Enhanced revision rhinoplasty with processed costal cartilage guided by preoperative CT and 3D scanning. European Archives of Oto-Rhino-Laryngology, 2024, 281 (9): 4221-4229. doi: 10.1007/s00405-024-00422-z.
[8] Wang B, Dai Y, Chang L et al. The diagnostic utility of CT attenuation values in detecting calcification within costal cartilage. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2024, 99, 103-109. doi: 10.1016/j.bjps.2024.09.066.
[9] Windfuhr J.P, Chen Y.S, Güldner C et al. Rib cartilage harvesting in rhinoplasty procedures based on CT radiological data. Acta Oto-Laryngologica, 2011, 131, 67-71. doi: 10.3109/00016489.2010.502185.
[10] Zhang S, Zhen J, Li H et al. Characteristics of Chinese costal cartilage and costa calcification using dual-energy computed tomography imaging. Sci Rep, 2017, 7 (01): 2923.