The primary role of ultrasound in evaluating right-sided diaphragmatic humps and juxtadiaphragmatic masses: A review of 22 cases

Khan, Ali; Gould, Debby

doi:10.1016/s0009-9260(84)80206-8

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…In addition to its use in the study of diaphragmatic motion, ultrasonography is also useful in the evaluation of adjacent disease that might affect the diaphragm, including diaphragmatic eventration and hernias, free and loculated pleural fluid, subphrenic abscess, hepatic abscess, metastatic disease, hydatid cyst, and amoebic abscess, 24 thoracic masses (pleural angiomyoliposarcoma, mesothelioma, metastatic adenocarcinoma, metastatic osteogenic sarcoma, malignant synovioma, and Wilms' tumor), 25 and rupture of the diaphragm. 26 Many if not most of these abnormalities will not be detected on fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic evaluation of diaphragmatic motion.

Gerscovich

Cronan

McGahan

et al. 2001

J of Ultrasound Medicine

277

213

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Objective. To evaluate the technical feasibility and utility of ultrasonography in the study of diaphragmatic motion at our institution. Methods. The study consisted of 2 parts. For part I, in 23 volunteers we performed 23 studies on 46 hemidiaphragms with excursions documented on M-mode ultrasonography. For part II, in 22 patients we performed 52 studies in 102 hemidiaphragms. In 50 studies both hemidiaphragms were studied, and in another 2 studies only 1 hemidiaphragm was studied. Patients' ages ranged from birth to 66 years (mean, 23 years). There were 16 male and 6 female patients. Indications for the study were (1) suggestion of paralysis of the diaphragm (n = 22); (2) if the diaphragm was already known to be paralyzed, for evaluation of response to phrenic nerve or pacer stimulation (n = 9); and (3) follow-up of previous findings (n = 21). Patients were examined in the supine position in the longitudinal semicoronal plane from a subcostal or low intercostal approach. Motion was documented with real-time ultrasonography and measured with M-mode ultrasonography. Results. Of the 102 clinical hemidiaphragms studied, findings included normal motion (n = 42), decreased motion (n = 22), no motion (n = 6), paradoxical motion (n = 10), positive pacer response (n = 13), negative pacer response (n = 2), positive phrenic stimulation (n = 6), and negative phrenic stimulation (n = 1). There were no failures of visualization. Conclusions. Ultrasonography proved feasible and useful in evaluating diaphragmatic motion. In our practice it has replaced fluoroscopy. Ultrasonography has advantages over traditional fluoroscopy, including portability, lack of ionizing radiation, visualization of structures of the thoracic bases and upper abdomen, and the ability to quantify diaphragmatic motion.

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic evaluation of diaphragmatic motion.

Gerscovich

Cronan

McGahan

et al. 2001

J of Ultrasound Medicine

277

213

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“…In clinical practice, an elevated hemidiaphragm on the chest radiograph should prompt consideration of diaphragm function testing. US can help to determine whether the diaphragm elevation results from intrinsic paralysis, organomegaly, or masses pushing the muscle upwards [44,45]. Recent studies underline the role of the technique in assessing a wide range of chronic diseases, such as neurological, neuromuscular and respiratory conditions.…”

Section: Review Findingsmentioning

confidence: 99%

“…There are also some initial reports suggesting a role for US in the diagnosis of infectious (e.g. subphrenic abscess) and neoplastic diseases of the diaphragm [45,47]. Diaphragmatic dysfunction as a result of phrenic nerve paralysis due to trauma, cardiothoracic or neck surgery can be detected by the technique [30,34,48].…”

Section: Review Findingsmentioning

confidence: 99%

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A Review of the Ultrasound Assessment of Diaphragmatic Function in Clinical Practice

et al. 2016

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Ultrasonography is the only non-invasive, non-ionizing imaging technique widely available to directly assess diaphragmatic function. Two different sonographic approaches permit the assessment of muscle thickening in the zone of apposition and excursion of the dome of the diaphragm. Thanks to the new hand-held ultrasound instruments, the morphology and function of the diaphragm can be assessed in different settings, such as outpatient clinic, pulmonary function test laboratory, hospital department and intensive care unit, and under different conditions. Despite the existence of different acoustic views and several codified approaches, a comprehensive sonographic examination has never been standardized for clinical use. In this review, we summarize the clinical indications, methods and perspectives of the technique in adults.

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“…Small herniations are typically asymptomatic, and diagnosis can be delayed for many years [5-7]. The diagnosis can be made when a defect of the diaphragm and/or liver parenchyma is observed on imaging studies such as ultrasonography (US) [8], CT [9], isotopic liver tomogram [10] or magnetic resonance imaging (MRI) [11]. Herniation may be difficult to differentiate from an intrathoracic tumor, especially when only a small portion of the liver is herniated.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic diaphragmatic herniation of the liver, examined by positron emission tomography: case report

et al. 2011

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We present a case of post-traumatic diaphragmatic herniation of the liver, which mimicked an intrathoracic tumor. After an automobile accident, the patient underwent thoracotomies for hemothorax and lung cancer in the right chest. Seven months later, computed tomography (CT) demonstrated a round tumor in the thorax adjacent to the right diaphragm with a higher density than the liver parenchyma. An intrathoracic tumor including a primary or metastatic lung cancer was suspected. However, positron emission tomography (PET) showed that the uptake of fluorine-18-fluorodeoxyglucose (FDG) was identical to that in the liver, and the tumor appeared to be contiguous with the liver. Thus, we suspected liver herniation. Core needle biopsy revealed liver cells without neoplastic tissue. Upon surgical exploration, herniation of the liver was found and repaired. PET was helpful in providing morphological and functional information leading to accurate diagnosis of liver herniation in this unusual case.

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The primary role of ultrasound in evaluating right-sided diaphragmatic humps and juxtadiaphragmatic masses: A review of 22 cases

Cited by 12 publications

References 12 publications

Ultrasonographic evaluation of diaphragmatic motion.

Ultrasonographic evaluation of diaphragmatic motion.

A Review of the Ultrasound Assessment of Diaphragmatic Function in Clinical Practice

Post-traumatic diaphragmatic herniation of the liver, examined by positron emission tomography: case report

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