The role of MRI in traumatic rupture of the diaphragm. Our experience in three cases and review of the literature.
OBJECTIVE
To evaluate the role and effectiveness of Magnetic Resonance Imaging (MRI) in blunt diaphragmatic injuries by reviewing the literature and our experience in three cases.


METHODS
We reviewed the medical records and MRI findings of three patients with diaphragmatic injury due to blunt abdominal trauma. All patients were previously examined with chest X-ray and CT and later with MRI at our institution. Coronal and sagittal SE TI-w and fast SE T2-w sequence images were acquired. All patients underwent surgery.


RESULTS
MRI showed a 5.5 cm tear in the left hemidiaphragmatic dome with herniation of the stomach and colon into the thoracic cavity in the first case; a 1 cm tear in the diaphragmatic dome with herniation of the stomach and posterior abscess in the second case; and an 8 cm breach in the left diaphragm with visceral herniation in the third case.


CONCLUSIONS
The major advantage of MRI lies in its capability of directly acquiring coronal and sagittal images allowing evaluation of the entire diaphragm, both in normal and in pathological conditions. In our experience, MRI showed the exact site and size of the diaphragmatic rupture in all cases. However, this technique cannot be performed in emergency situations or in multitrauma patients. Therefore, in agreement with the literature, helical CT remains the modality of choice in traumatic patients. MR imaging is useful only in doubtful cases and in haemodynamically stable patients.
Barbiera
Filippo
F
Dipartimento di Biotecnologie Mediche e Medicina Legale, Sezione di Scienze Radiologiche, Azienda Universitaria Ospedaliera Policlinico, Università degli Studi di Palermo, Palermo, Italy. barbiera@inwind.it
Nicastro
Nicola
N
Finazzo
Mario
M
Lo Casto
Antonio
A
Runza
Giuseppe
G
Bartolotta
Tommaso Vicenzo
TV
Midiri
Massimo
M
D000293:Adolescent; D000328:Adult; D006549:Hernia, Diaphragmatic, Traumatic / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000601:surgery