title: Imaging of diaphragmatic injury: a diagnostic challenge?
abstract: Diaphragmatic injuries occur in 0.8%-8% of patients after blunt trauma. Although the diagnosis may be obvious at standard chest radiography or computed tomography (CT) in most situations, some more subtle signs require careful analysis of CT images and examination with magnetic resonance (MR) imaging in some specific situations. Each method of imaging evaluation has advantages and pitfalls according to the type of diaphragmatic rupture. MR imaging with breath-hold acquisition permits good visualization of diaphragmatic abnormalities, but this technique cannot be performed in emergency situations. Because of a dramatic reduction in motion and beam-hardening artifacts and significant improvement of spatial resolution, especially along the z axis, helical CT and multisection CT allow better demonstration of the most subtle signs, such as a focal indentation of the liver or a right-sided collar sign. In addition, helical CT and multisection CT are useful tools in the evaluation of patients with multiple traumatic injuries.
authors.affiliation: Department of Radiology Imagerie Guilloz, Hôpital Central, 29 Avenue de Lattre de Tassigny, 54035 Nancy, France. s.iohum@chu-nancy.fr
authors.forename: Sandrine
authors.initials: S
authors.lastname: Iochum
authors.forename: Thomas
authors.initials: T
authors.lastname: Ludig
authors.forename: Frédéric
authors.initials: F
authors.lastname: Walter
authors.forename: Hugues
authors.initials: H
authors.lastname: Sebbag
authors.forename: Gilles
authors.initials: G
authors.lastname: Grosdidier
authors.forename: Alain G
authors.initials: AG
authors.lastname: Blum
mesh_terms: D003964:Diaphragm / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008279:Magnetic Resonance Imaging; D009104:Multiple Trauma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012421:Rupture / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*