Assessment of diaphragmatic motion after lung resection using magnetic resonance imaging.
OBJECTIVE
The aim of this study was to assess quantitatively the impairment of diaphragmatic motion after lung resection, with special reference to the location of the resected lobe, duration of the postoperative period, and patient posture. We used magnetic resonance imaging to make the assessments.


METHODS
In 44 patients (29 men, 15 women; mean age 62.2 years) with lung cancer, diaphragmatic motion was measured during maximum deep, slow breathing using a spoiled gradient-recalled echo sequence before and after lung resection. The study group consisted of 34 patients who were examined using a 1.5-T unit in the supine position and 10 patients using a vertically open 0.5-T unit in both the sitting and supine positions. The influence of surgery site and patient posture on diaphragmatic motion after lung resection was investigated.


RESULTS
In all cases after lung resection, diaphragmatic motion on the operated side was significantly decreased (P < 0.001), and that on the nonoperated side was significantly increased (P = 0.045). After left upper lobectomy and right bilobectomy, the diaphragmatic motion on the operated side was significantly decreased (P < 0.001), and that of the other side was significantly increased (P < 0.001). The diaphragmatic motion was not significantly changed after right middle lobectomy. The diaphragmatic motion on the operated side was impaired significantly more (P = 0.035) in the supine position than in the sitting position.


CONCLUSIONS
After lobe resection, diaphragmatic motion was impaired more significantly in the supine than in the sitting position; and it differed according to the location of the resected lobe. The improvement in diaphragmatic function after lobectomy was observed over a period of 3-24 months.
Takazakura
Ryutaro
R
Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, 520-2192, Japan. rtryu@belle.shiga-med.ac.jp
Takahashi
Masashi
M
Nitta
Norihisa
N
Sawai
Satoru
S
Tezuka
Noriaki
N
Fujino
Shozo
S
Murata
Kiyoshi
K
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003964:Diaphragm / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008168:Lung / Q000601:surgery*; D008175:Lung Neoplasms / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009038:Motion; D011184:Postoperative Period; D011187:Posture; D012119:Respiration; D016683:Supine Position; D013997:Time Factors