Imaging hemidiaphragmatic injury.
The supine chest radiograph is the initial and most commonly performed imaging study to evaluate the thorax after trauma. Whenever the chest radiograph is equivocal or suspicious for acute diaphragmatic injury (DI), computed tomography (CT) is usually the next study of choice since it is both generally available and often used to examine other body regions in the patient after trauma. CT is usually diagnostic, particularly if supplemented by multiplanar reformation (MPR) obtained using thin-slice axial scanning and overlapping images for reformations. Magnetic resonance imaging (MRI) is potentially useful to assess the diaphragm if CT findings are indeterminate and the patient is stable enough to have the procedure. Simple T1-weighted spin-echo images in the sagittal and coronal orientation are usually sufficient to establish or exclude DI. This article reviews imaging modalities and strategies for diagnosing DI from blunt trauma.
Mirvis
Stuart E
SE
Department of Diagnostic Radiology and the Maryland Shock-Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA. smirvis@umm.edu
Shanmuganagthan
Kathirkamanathan
K
D003287:Contrast Media; D003964:Diaphragm / Q000293:injuries*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011300:Preoperative Care; D013902:Radiography, Thoracic / Q000379:methods*; D013898:Thoracic Injuries / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*
D003287:Contrast Media