Skip to main content

Advertisement

Log in

Assessment of diaphragmatic motion after lung resection using magnetic resonance imaging

  • ORIGINAL ARTICLE
  • Published:
Radiation Medicine Aims and scope Submit manuscript

Abstract

Purpose

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.

Materials and 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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. InstitutionalAuthorNameBritish Thoracic Society (2001) ArticleTitleSociety of Cardiothoracic Surgeons of Great Britain and Ireland Working Party. Guidelines on the selection of patients with lung cancer for surgery Thorax 56 89–108 Occurrence Handle10.1136/thorax.56.2.89

    Article  Google Scholar 

  2. Y Sekine T Iwata M Chiyo K Yasufuku S Motoashi S Yoshida et al. (2003) ArticleTitleMinimal alteration of pulmonary function after lobectomy in lung cancer patients with chronic obstructive pulmonary disease Ann Thorac Surg 76 356–61 Occurrence Handle12902063 Occurrence Handle10.1016/S0003-4975(03)00489-2

    Article  PubMed  Google Scholar 

  3. KG Nielsen K Holte H Kehlet (2003) ArticleTitleEffects of posture on postoperative pulmonary function Acta Anaesthesiol Scand 47 1270–5 Occurrence Handle14616326 Occurrence Handle10.1046/j.1399-6576.2003.00240.x Occurrence Handle1:STN:280:DC%2BD3srjs1Wgtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. DS Gierada JJ Curtin SJ Erickson RW Prost JA Strandt LR Goodman (1995) ArticleTitleDiaphragmatic motion: fast gradient-recalled-echo MR imaging in healthy subjects Radiology 194 879–84 Occurrence Handle7862995 Occurrence Handle1:STN:280:DyaK2M7mslWnsQ%3D%3D

    PubMed  CAS  Google Scholar 

  5. T Iwasawa S Kagei T Gotoh Y Yoshiike K Matsushita H Kurihara et al. (2002) ArticleTitleMagnetic resonance analysis of abnormal diaphragmatic motion in patients with emphysema Eur Respir J 19 225–31 Occurrence Handle11866002 Occurrence Handle10.1183/09031936.02.00044602 Occurrence Handle1:STN:280:DC%2BD387jtVOktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. O Etlik ME Sakarya K Uzun M Harman O Temizoz A Durmus (2004) ArticleTitleDemonstrating the effect of theophylline treatment on diaphragmatic movement in chronic obstructive pulmonary disease patients by MR-fluoroscopy Eur J Radiol 51 150–4 Occurrence Handle15246520 Occurrence Handle10.1016/S0720-048X(03)00210-9

    Article  PubMed  Google Scholar 

  7. O Unal H Arslan K Uzun B Ozbay ME Sakarya (2000) ArticleTitleEvaluation of diaphragmatic movement with MR fluoroscopy in chronic obstructive pulmonary disease Clin Imaging 24 347–50 Occurrence Handle11368935 Occurrence Handle10.1016/S0899-7071(00)00245-X Occurrence Handle1:STN:280:DC%2BD3MzjsVKkuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. K Suga T Tsukuda H Awaya K Takano S Koike N Matsunaga et al. (1999) ArticleTitleImpaired respiratory mechanics in pulmonary emphysema: evaluation with dynamic breathing MRI J Magn Reson Imaging 10 510–20 Occurrence Handle10508317 Occurrence Handle10.1002/(SICI)1522-2586(199910)10:4<510::AID-JMRI3>3.0.CO;2-G Occurrence Handle1:STN:280:DyaK1Mvjsl2nsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. R Takazakura M Takahashi N Nitta K Murata (2004) ArticleTitleDiaphragmatic motion in the sitting and supine positions: healthy subject study using a vertically open magnetic resonance system J Magn Reson Imaging 19 605–9 Occurrence Handle15112310 Occurrence Handle10.1002/jmri.20051

    Article  PubMed  Google Scholar 

  10. Y Asada N Tezuka T Konishi S Asakura S Fujino H Kato et al. (1995) ArticleTitleAnalysis of chest wall and diaphragm movement after lung cancer operation by Turbo-FLASH Cine mode MRI Haigan Shujyutu Shugi 8 46–58

    Google Scholar 

  11. M Nonaka M Kadokura N Tanio S Yamamoto D Kataoka K Inoue et al. (1998) ArticleTitleChanges in lung lobar volume and bronchial deformity after right upper lobectomy Surg Today 28 285–8 Occurrence Handle9548310 Occurrence Handle10.1007/s005950050122 Occurrence Handle1:CAS:528:DyaK1MXksFGhtL0%3D

    Article  PubMed  CAS  Google Scholar 

  12. MD Fratacci WR Kimball JC Wain RM Kacmarek DM Polaner WM Zapol (1993) ArticleTitleDiaphragmatic shortening after thoracic surgery in humans: effects of mechanical ventilation and thoracic epidural anesthesia Anesthesiology 79 654–65 Occurrence Handle8214744 Occurrence Handle1:STN:280:DyaK2c%2FivVWisA%3D%3D Occurrence Handle10.1097/00000542-199310000-00005

    Article  PubMed  CAS  Google Scholar 

  13. H Maeda K Nakahara K Ohno T Kido M Ikeda Y Kawashima (1988) ArticleTitleDiaphragm function after pulmonary resection: relationship to postoperative respiratory failure Am Rev Respir Dis 137 678–81 Occurrence Handle3345047 Occurrence Handle1:STN:280:DyaL1c7kvVGqtQ%3D%3D

    PubMed  CAS  Google Scholar 

  14. MK Ali CF Mountain MS Ewer D Johnston TP Haynie (1980) ArticleTitlePredicting loss of pulmonary function after pulmonary resection for bronchogenic carcinoma Chest 77 337–342 Occurrence Handle7357934 Occurrence Handle1:STN:280:DyaL3c7jtlOisw%3D%3D

    PubMed  CAS  Google Scholar 

  15. P Cluzel T Similowski C Chartrand-Lefebvre M Zelter JP Derenne PA Grenier (2000) ArticleTitleDiaphragm and chest wall: assessment of the inspiratory pump with MR imaging-preliminary observations Radiology 215 574–83 Occurrence Handle10796942 Occurrence Handle1:STN:280:DC%2BD3c3lslSjug%3D%3D

    PubMed  CAS  Google Scholar 

  16. LS Brandi R Bertolini A Janni A Gioia CA Angeletti (1996) ArticleTitleEnergy metabolism of thoracic surgical patients in the early postoperative period: effect of posture Chest 109 630–7 Occurrence Handle8617069 Occurrence Handle1:STN:280:DyaK287otFOquw%3D%3D

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ryutaro Takazakura.

About this article

Cite this article

Takazakura, R., Takahashi, M., Nitta, N. et al. Assessment of diaphragmatic motion after lung resection using magnetic resonance imaging. Radiat Med 25, 155–163 (2007). https://doi.org/10.1007/s11604-007-0119-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-007-0119-5

Key words

Navigation