[Echographic aspect of the diaphragm]

The authors investigated the sonographic patterns of the right hemidiaphragm, with high-resolution real-time equipments. Sixty healthy subjects and two patients were examined; the patients suffered from ascites and pleural effusion, and ascites and pulmonary emphysema, respectively. Even though the muscle is generally described as a thin, highly echogenic line surrounding the liver, in a large number of cases the diaphragm could be demonstrated as a hypoechoic layer, bordered by thin echogenic lines (pleural and peritoneal membranes). This pattern was observed in the lateral part of the muscle in 81% of cases, and along the whole border of the liver in 37% of cases. Such findings were detected in pathological cases too. Thus, the patterns described in previous experimental works on specimens of human diaphragm were confirmed in vivo. As the perfect knowledge of normal appearance is the first step towards diagnosis, the above peculiarities of the normal diaphragm should become more widely known.