Study Of Normal Diaphragm And Diaphragmatic Hernia On CT MPR

Objective:To determine the visibility of different part of both sides the of the diaphragm on spiral CT multi-planar reconstruction (MPR) and inflence factor.To explore the normal range of diaphragm thickness on CT and its clinical value. To explore the value of CT MPR in diagnosing diaphragmatic hernia and clinical significance.Materials and methods:A total of 200 adults were consecutively recruited and scanned with 40 slice MDCT at the end of deep inspiration. The visibility and morphological characteristics' of both sides of the diaphragm were observed on CT MPR of different part of the diaphragm,the visibility rate were calculated,the influence factor were analyzed and the thickness were measured. In additional,23 cases were recorded and analyzed(15 cases of esophageal hiatus hernia,3 cases of traumatic diaphragmatic hernia,2 cases of diaphragmatic eventuation,2 cases of triangle hernia between vertebral lumbar and rib and 1 case of diaphragmatic hernia occurred after operation).The performance of the location of hernia, diaphragmatic continuity, the size of diaphragmatic hernia defect, organs into the chest and CT features of different serial were observed.Results:The visibility rate of the front of right diaphragm is 91%, the visibility rate of the center of right diaphragm is 33%, and the visibility rate of the rear of right diaphragm is 98.5%. The visibility rate of the front of left diaphragm is 92%, the visibility rate of the front of left diaphragm is 94%, and the visibility rate of the center of right diaphragm is 99%. Observed on CT images of normal diaphragm forms a continuous arc or even a continuous wave of varying thickness. The former diaphragm shape is after deep inspiration, while the latter is of the muscle bundle hypertrophy or muscle bundle performance. The thickness of different parts of both sides of the diaphragm can not indicate statistically significant difference.The thickness is 2.24±1.18mm.The various types of diaphragmatic hernia show diaphragmatic discontinuity, most accompanied by abdominal viscera herniated into the chest. CT MPR can show a false diaphragm in chest, the specific organs herniated into the chest, hernia sac size, the relationship of the organs and tissues herniated into the chest and the diaphragm hole size. Conclusion:The visibility rate of different part of both sides of the diaphragm on CT MPR is different. The thickness of different parts of both sides of the diaphragm can not indicate statistically significant difference.The thickness is 2.24±1.18mm.Spiral CT MPR can clearly show the diaphragmatic hiatus and also can precisely measure the diameter of diaphragmatic hernia. It plays an important role in diagnosing various types of diaphragmatic hernia and differentiation of related diseases, can guide to choose appropriate clinical approach and manner.