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Variation in diaphragm position and shape in adults with normal pulmonary function.
Thitiporn Suwatanapongched1, David S Gierada, Richard M Slone
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Chest
|June 11, 2003
Summary
Diaphragm position and shape on chest X-rays show significant variability. Factors like age, weight, and thoracic dimensions influence these normal variations, aiding radiographic interpretation.
Area of Science:
- Radiology
- Pulmonary Medicine
- Anatomy
Background:
- Diaphragm position and shape on chest radiographs are key indicators of lung volume.
- Previous studies lacked objective measurements and pulmonary function data, failing to address variability.
Purpose of the Study:
- To objectively measure diaphragm position and shape in patients with normal pulmonary function.
- To identify relationships between diaphragm morphology and demographic/thoracic variables.
Main Methods:
- Prospective, cross-sectional observational study at a university hospital.
- 153 adults with normal FEV1 and total lung capacity underwent chest radiography.
- Objective measurements of diaphragm position and shape were analyzed.
Main Results:
- Established normal ranges for diaphragm position (vertebral levels) and shape (radius, height/AP dimension ratio).
- Diaphragm position correlated with age, weight, and thoracic dimensions; shape correlated with age, weight, thoracic dimensions, smoking history, and gender.
- Demographic and thoracic variables explained 31-38% of the variability in diaphragm position and shape.
Conclusions:
- Significant variability exists in normal diaphragm position and shape.
- Weight, age, and thoracic dimensions are key factors influencing diaphragm morphology.
- Accounting for these factors can improve chest radiograph interpretation.