Imaging-Anatomic Study Of Diaphragmatic Lumbocostale And Ternocostal Triangle With Double-phase 16-row MDCT

Purpose: To determine the effect of the respiratory phase, age, sex and bodymass indexes (BMI) on visibility and morphological characteristics of thediaphragmatic stemocostal and lumbocostal triangle in normal adult shownon MDCT.Materials and Methods: A total of 100 normal adults were consecutivelyrecruited and scanned with 16-row MDCT at the end of deep expiration andinspiration. The visibility and morphological characteristics of thediaphragmatic stemocostal and lumbocostal triangle were observed. All caseswere grouped according to the respiratory phase, age, sex and BMI,respectively. The visibility on MDCT among different types of thestemocostal and lumbocostal triangle at the inspiratory or the expiratoryphases were calculated and compared, and the visibility rate was correlatedwith age, sex, and BMI, respectively. In additional, CT features ofdiaphragmatic hernia (n=4) were recorded and analyzed.Results: The visibility rate of the stemocostal triangle was 43% at the end ofinspiration and 32% at the end of expiration. No difference was found amongages, genders and BMI (p＞0.05). However, the visibility rate of thelumbocostal triangle was 35% at the end of inspiration and the morphologic characteristics were classified into 3 types, including typeⅠ, typeⅡand typeⅢ(54%, 11% and 35%, respectively), While the visibility rate of thelumbocostal triangle was 28% at the end of expiration, and typeⅠ, typeⅡaswell as typeⅢwas 61%, 11% and 28%, respectively. Considerable differencewith higher visibility rate of the lumbocostal triangle was noted in eldergroup (p＜0.05), whereas the differences in visibility rate of the lumbocostaltriangle among genders and BMI were not significant (p＞0.05). Rupture ofdiaphragm and the features of adjacent abdominal organs into thoracic cavitywere revealed clearly on MPR images of MDCT in 4 patients withdiaphragmatic hernia.Conclusion: The visibility of the diaphragmatic sternocostal and lumbocostaltriangle were associated with the respiratory movement. Age may be animportant factor influencing the visibility rate of the lumbocostal triangle.MPR on MDCT could be useful to reveal the anatomic structure ofdiaphragm and radiological features of diaphragmatic hernia. Furthermore,double-phase scanning of MDCT could provide feasible method to study thephysiologic information of diaphragm movement on normal and abnormalstatus.