title: Left hemidiaphragmatic mobility: assessment with ultrasonographic measurement of the craniocaudal displacement of the splenic hilum and the inferior pole of the spleen.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the correlation between the radiographic and ultrasonographic measurements of craniocaudal displacement of the left hemidiaphragm.
  
  
  METHODS
  Forty-nine patients with clinical indications for interventional procedures prospectively underwent radiographic evaluation of left hemidiaphragmatic mobility and B-mode ultrasonographic measurement of craniocaudal displacement of the hilum and the inferior pole of the spleen. Ultrasonography was performed with a 3.5-MHz convex transducer in a left intercostal position under a longitudinal orientation. Statistical analyses were performed with linear regression, a paired Student t test, and Bland-Altman analyses.
  
  
  RESULTS
  The correlation between the craniocaudal splenic hilum displacement and radiographic measurements was found to be linear: hemidiaphragmatic mobility = 17.795 + 0.429 x splenic hilum displacement (SE for the regression coefficient = 0 .12; P = .0012), although the values obtained with both methods were statistically different (P < .05). The same results could be observed with the use of the inferior pole of the spleen: hemidiaphragmatic mobility = 9.5596 + 0.5455 x inferior polo displacement (SE for the regression coefficient = 0 .11; P < .0001). The mean difference between the values obtained by ultrasonography and by radiography was statistically significant (16.7 +/- 16.1 mm; P < .05 [hilum]; 18.9 +/- 14.2 mm; P < .05 [inferior pole]).
  
  
  CONCLUSIONS
  These results allow us to conclude that ultrasonography can be used as an alternative method for left hemidiaphragm mobility evaluation compared with radiography.
authors.affiliation: Liver Unit, University of São Paulo Medical School, Brazil. tolecosta@hotmail.com
authors.forename: Nair S G
authors.initials: NS
authors.lastname: Toledo
authors.forename: Sergio K
authors.initials: SK
authors.lastname: Kodaira
authors.forename: Paulo C B
authors.initials: PC
authors.lastname: Massarollo
authors.forename: Osvaldo I
authors.initials: OI
authors.lastname: Pereira
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Dalmas
authors.forename: Giovanni Guido
authors.initials: GG
authors.lastname: Cerri
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Buchpiguel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003964:Diaphragm / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013154:Spleen / Q000000981:diagnostic imaging*; D014159:Transducers; D014463:Ultrasonography