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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:41-49 • 0278-4297

Left Hemidiaphragmatic Mobility

Assessment With Ultrasonographic Measurement of the Craniocaudal Displacement of the Splenic Hilum and the Inferior Pole of the Spleen

Nair S. G. Toledo, PT, PhD, Sergio K. Kodaira, MD, PhD, Paulo C. B. Massarollo, MD, PhD, Osvaldo I. Pereira, MD, PhD, José Carlos Dalmas, PhD, Giovanni Guido Cerri, MD, PhD and Carlos A. Buchpiguel, MD, PhD

Liver Unit (P.C.B.M.) and Department of Radiology (N.S.G.T., S.K.K., O.I.P., G.G.C., C.A.B.), University of São Paulo Medical School, São Paulo, Brazil; and Department of Applied Mathematics and Statistics, State University of Londrina, Londrina, Brazil (J.C.D.).

Address correspondence to Nair S. G. Toledo, PT, PhD, R Benjamin Franklin 220, (3)-CEP 86063-240 Londrina, Brazil. E-mail: tolecosta{at}hotmail.com

Objective. The purpose of this study was to evaluate the correlation between the radiographic and ultrasonographic measurements of craniocaudal displacement of the left hemidiaphragm. Methods. Forty-nine patients with clinical indications for interventional procedures prospectively underwent radiographic evaluation of left hemidiaphragmatic mobility and B-mode ultrasonographic measurement of craniocaudal displacement of the hilum and the inferior pole of the spleen. Ultrasonography was performed with a 3.5-MHz convex transducer in a left intercostal position under a longitudinal orientation. Statistical analyses were performed with linear regression, a paired Student t test, and Bland-Altman analyses. Results. The correlation between the craniocaudal splenic hilum displacement and radiographic measurements was found to be linear: hemidiaphragmatic mobility = 17.795 + 0.429 x splenic hilum displacement (SE for the regression coefficient = 0 .12; P = .0012), although the values obtained with both methods were statistically different (P < .05). The same results could be observed with the use of the inferior pole of the spleen: hemidiaphragmatic mobility = 9.5596 + 0.5455 x inferior polo displacement (SE for the regression coefficient = 0 .11; P < .0001). The mean difference between the values obtained by ultrasonography and by radiography was statistically significant (16.7 ± 16.1 mm; P < .05 [hilum]; 18.9 ± 14.2 mm; P < .05 [inferior pole]). Conclusions. These results allow us to conclude that ultrasonography can be used as an alternative method for left hemidiaphragm mobility evaluation compared with radiography.

Key Words: diaphragm • splenic structures • ultrasonography • ultrasound physics

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.