Ultrasonographic evaluation of the diaphragm

• Published in: The Egyptian Journal of Bronchology Vol. 13; no. 5; pp. 690 - 698
• Main Authors: Sabri, Youssriah Y., Hussein, Sabah A. M., Baz, Ahmed A. M., Aglan, Amal A. M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2019; Wolters Kluwer India Pvt. Ltd; Springer Nature B.V; SpringerOpen
• Subjects: diaphragm function; diaphragm morphology; Medicine & Public Health; Original Article; Ultrasonic imaging; ultrasonography; ultrasonography; diaphragm function; diaphragm morphology
• ISSN: 1687-8426; 2314-8551
• DOI: 10.4103/ejb.ejb_73_19

Background
Ultrasonography is a promising technique for structural and functional evaluation of the diaphragm. It is accurate, reproducible, and portable with no ionizing radiation. Multiple studies have reported ultrasonography as the modality of choice for evaluation of the diaphragm.
Objective
The aim was to assess the role of ultrasound (US) in the evaluation of the diaphragm, either normal or abnormal, through evaluating its morphology, integrity, and measuring different parameters such as diaphragmatic thickness, thickening fraction, and excursion with proper assessment of supra/infradiaphragmatic lesions that affect the diaphragm.
Patients and methods
In all, 118 patients were recruited from the Chest and Radiology Departments, Cairo University, in the period from January to July 2019. All patients were subjected to history taking, clinical examination, and ultrasonographic assessment of the diaphragm. High-frequency linear transducer of 7.5–12 MHz was used for imaging the diaphragm and measuring its thickness. A low-frequency curvilinear transducer with a frequency of 3.5–5 MHz was used for assessing diaphragmatic excursion.
Results
Cases were grouped into two groups, those with normal US findings of the diaphragm represented group A, while patients with any diaphragmatic abnormality represented group B. Group B included 41 patients with intrinsic (56.09%) and extrinsic diaphragmatic abnormalities (46.34%). Five (12.2%) cases have thickened diaphragm; two (4.9%) cases have thinned-out diaphragm; two (4.9%) cases showed congenital diaphragmatic defects; three (7.3%) cases showed acquired diaphragmatic defects; 10 (24.4%) cases showed diaphragmatic weakness; and nine (21.95%) cases showed diaphragmatic paralysis (7.6%).
Conclusion
US is the technique of choice for assessing diaphragmatic movement on suspicion of malfunctioning. Ultrasonography is a promising technique for structural and functional evaluation of the diaphragm.