J Korean Radiol Soc. 2007 Sep;57(3):229-233. Korean.
Published online Sep 30, 2007.
Copyright © 2007 by The Korean Society of Radiology
Original Article

Computed Tomographic Appearance of the Anterior Diaphragm: Evaluation with 64-slice MDCT

Bum Sang Cho, M.D., Sung Jin Kim, M.D., Kil Sun Park, M.D., Sang Hoon Cha, M.D., Gi Seok Han, M.D., Il Hun Bae, M.D., Seung Young Lee, M.D. and Min Hee Jeon, M.D.
    • Department of Diagnostic Radiology, College of Medicine and Medical Research Institute, Chungbuk National University, Korea.

Abstract

Purpose

To re-evaluate the appearance of the anterior diaphragm by the use of MDCT.

Materials and Methods

We performed a retrospective review of 81 consecutive patients that underwent chest CT by using 64 channel MDCT. We classified the anterior diaphragm as three types (types 1-3) based on 5 mm axial scans: a line behind the xiphoid, a discontinuity and opening anteriorly, and the presence of broad and poorly defined bands. We also classified the anterior diaphragm as three types (types A-C) using 2 mm sagittal reformation images, based on the shape of the anterior diaphragmatic fibers traveling from the base of the pericardium to the xiphoid: a downward slope, an upward slope, and a flat shape, and compared the two groups using a correlation determined by statistical analysis.

Results

We could classify the appearance of the anterior diaphragm for all cases on the axial scans and sagittal reformation images. The number of types 1, 2, 3 on the axial scans was 30.9%, 38.3%, and 30.9% and the number of types A, B, C on the sagittal reformation images was 33.3%, 22.2%, and 44.4%, respectively. Type A was seen for 92% of type 1 cases, type C was seen for 88% of type 3 cases, and type B was seen for 54.8% of type 2 cases. The types seen between the axial and sagittal reformation images showed a significant agreement (r=0.868, p < 0.01).

Conclusion

The shape of the anterior diaphragm correlated with the relationship between the base of the pericardium and the xiphoid.

Keywords
Diaphragm; Anatomy; Tomography, X-Ray Computed; Xiphoid Bone


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