MR Imaging off Traumatic Diaphragmatic Rupture

Keramati, B; Buckman, Robert F.; Rodríguez, Aurelio

doi:10.1097/00004728-198801000-00030

Cited by 54 publications

(7 citation statements)

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“…Coronal and sagittal MRI with respiratory and cardiac gating may allow further confirmation of exclusion of the diagnosis in equivocal cases. 13,14 Unfortunately, obscure locations and difficult accessibility of the MRI scanners as well as incompatibility with the routine support devices that many trauma patients require has limited the role and use of MRI. Other imaging modalities include technetium-99m sulfur colloid scintigraphy and ultrasound.…”

Section: Discussionmentioning

confidence: 99%

CT with Coronal Reconstruction Identifies Previously Missed Smaller Diaphragmatic Injuries after Blunt Trauma

Bhullar

Block

2011

The American Surgeon™

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Diaphragmatic injuries (DIs) are difficult to diagnose and often go unrecognized after blunt trauma. We proposed that CT scan with coronal reconstruction (CTCR) improves the detection of small DIs missed by chest x-ray (CXR) and CT scan with axial views (CTAX). We performed a retrospective review at a Level I trauma center from 2001 to 2006 and identified 35 patients who underwent operative repair of DI after blunt trauma. The size of the DI and the radiographic test (CXR, CTAX, and CTCR) that identified the defect was compared. Results were analyzed using mean, Mann-Whitney U test, and Fisher exact test. Of the 35 DI repairs, nine were performed after CXR alone and 12 after identification by both a CXR and CTAX. There was no significant difference between the mean DI size identified by CXR with and without CTAX (10.6 vs 9.7, P = 0.88). The remaining 14 DIs were undetected by CXR and CTAX. Seven of these (before CTCR) were found during exploratory laparotomy and seven were identified by CTCR (4.6 cm vs 3.5 cm, P = 0.33). The mean DI size identified by CTCR was significantly smaller than that identified by CXR alone (4.6 cm vs 9.7 cm, P < 0.05) and by CXR and CTAX (4.6 cm vs 10.6 cm, P < 0.0005). CTCR improves the ability to detect smaller DI defects (4 to 8 cm) that were previously missed by CXR and CTAX. CTAX adds little to CXR alone for the diagnosis of large defects (greater than 8 cm).

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Section: Discussionmentioning

confidence: 99%

CT with Coronal Reconstruction Identifies Previously Missed Smaller Diaphragmatic Injuries after Blunt Trauma

Bhullar

Block

2011

The American Surgeon™

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“…Multisequence imaging provides tissue characterization and better differentiation between the intraabdominal organs and the diaphragm. MRI has been successful in diagnosing congenital diaphragmatic hernias and acute presentations of traumatic diaphragmatic rupture [12,13]. The use of MRI in the evaluation of delayed presentation of traumatic diaphragmatic hernia has not been previously described.…”

Section: Discussionmentioning

confidence: 99%

MRI diagnosis of delayed presentation of traumatic diaphragmatic hernia

Daum-Kowalski

Shanley

Murphy

1991

Gastrointest Radiol

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Traumatic rupture of the diaphragm may go unrecognized in patients with multiple injuries to the abdomen and chest. The majority of undiagnosed diaphragmatic ruptures will eventually become symptomatic and are associated with a high mortality rate if not treated immediately. Multiplanar imaging with magnetic resonance (MR) provided a definitive diagnosis of delayed presentation of traumatic diaphragmatic hernia.

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“…Mirvis et al [49] rapportent cependant un cas de rupture diaphragmatique diagnostiquée en phase précoce. Elle ne peut cependant aujourd'hui être considérée comme une technique à utiliser dans le cadre de l'urgence pour l'exploration d'un polytraumatisé.…”

Section: Aspect En Irmunclassified