Ultrasonographic evaluation of peridiaphragmatic lesions: A prospective study
Journal
Journal of Medical Ultrasound
Journal Volume
2
Journal Issue
2
Pages
84-92
Date Issued
1994
Author(s)
Abstract
Background: Conventional chest radiography has little value in the etiologic diagnosis of hemidiaphragm elevation or peridiaphragmatic lesions. This study prospectively assesses the diagnostic value of chest ultrasound (US) for the diagnosis of hemidiaphragmatic elevation or peridiaphragmatic lesions of unknown etiology. Materials and methods: A total of 56 patients with radiographic evidence of peridiaphragmatic abnormality or elevation of hemidiaphragm with unknown causes were included in this study over a period of two years. Forty patients had lesions at right hemidiaphragm and 16 left hemidiaphragm. All patients were examined by high resolution real-time US by two sonographers without knowing their clinical diagnoses. Thirty-nine patients had also received a chest computed tomography (CT) scan; 24 received end expiratory and inspiratory chest radiographs, and two had received magnetic resonance image for further confirmation of the etiologies of their diaphragmatic abnormalities. Results: The US diagnoses of peridiaphragmatic lesions were divided into three areas: supradiaphragmatic, diaphragmatic and infradiaphragmatic. Thirty-seven patients had hemidiaphragm elevation due to supradiaphragmatic lesions, 24 patients had diaphragmatic and 14 patients had intradiaphragmatic processes. Seventeen patients were confirmed as having more than two major paradiaphragmatic abnormalities simultaneously by US, leading to hemidiaphragm elevation. All the supradiaphragmatic and infradiaphragmatic lesions causing diaphragmatic abnormalities could be diagnosed by US, and the diagnostic sensitivity of chest US was compatible to that of CT. However, US was superior to CT for demonstration of abnormalities of diaphragmatic motion, such as diaphragmatic palsy, because of the capability of real-time observation of diaphragm mobility. Conclusion: Chest US is a very useful primary imaging tool for evaluation of radiographic evidence of diaphragmatic abnormalities with unknown etiology.
SDGs
Other Subjects
article; diaphragm disease; echography; female; hemidiaphragm; human; major clinical study; male
Publisher
Elsevier (Singapore) Pte Ltd
Type
journal article