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The Diaphragm

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Comparative Interpretation of CT and Standard Radiography of the Chest

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Radiology of the diaphragm may be difficult, mainly because there is no imaging technique that can clearly and entirely visualize the diaphragm. Although we usually speak of the top of the opaque abdominal mass as the diaphragm on a chest X-ray, this is not the diaphragm itself because this structure is only directly visible on this chest X-ray when there is abnormal abdominal air below and normal lung parenchyma above it. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are the only imaging modalities that can visualize the diaphragm itself, although visualization is usually partial and dependent on the presence of pleural disease when using US and on the presence of subdiaphragmatic fat when using CT and MRI. In general, the aim of the standard chest X-ray for diaphragmatic imaging is threefold: (1) Looking for diaphragmatic pathology, which is often an incidental finding on the chest X-ray. (2) Given the fact that the diaphragm is not directly visible on a chest X-ray, deciding whether the abnormality is indeed located in the diaphragm or whether what is seen is secondary to other disease located adjacent to the diaphragm. (3) Because of the variable presentation of the diaphragm, many changes seen on a chest X-ray are not related to pathology or to “important” pathology, so a decision needs to be made about the importance of the finding and the necessity of performing additional imaging. A complete or focal change in the contour delineation of the diaphragm (irregularity, disappearance); a unilateral, bilateral, or focal elevation; and a unilateral, bilateral, or focal depression are the three basic changes of the diaphragm that can be seen on a chest X-ray.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Johny A. Verschakelen

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  1. Johny A. Verschakelen
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Editors and Affiliations

  1. Clinique Saint Luc, Dept. Radiology, Université Catholique Louvain, avenue Hippocrate 10, Bruxelles, 1200, Belgium

    Emmanuel E. Coche

  2. Service Imagerie Médicale, CHU de Liège, Liège, 4000, Belgium

    Benoit Ghaye

  3. Academisch Ziekenhuis, Afd. Radiologie, Vrije Universiteit Brussel, Laarbeeklaan 101, Bruxelles, 1090, Belgium

    Johan de Mey

  4. Academisch Ziekenhuis, Afd. Radiologie, Universiteit Gent, De Pintelaan 185, Gent, 9000, Belgium

    Philippe Duyck

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Verschakelen, J.A. (2011). The Diaphragm. In: Coche, E., Ghaye, B., de Mey, J., Duyck, P. (eds) Comparative Interpretation of CT and Standard Radiography of the Chest. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79942-9_12

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  • DOI: https://doi.org/10.1007/978-3-540-79942-9_12

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-79941-2

  • Online ISBN: 978-3-540-79942-9

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