Two-dimensional ultrasound imaging of the diaphragm: Quantitative values in normal subjects

Introduction: Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods: We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with resu...

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Published inMuscle & nerve Vol. 47; no. 6; pp. 884 - 889
Main Authors Boon, Andrea J., Harper, Caitlin J., Ghahfarokhi, Leili Shahgholi, Strommen, Jeffrey A., Watson, James C., Sorenson, Eric J.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.06.2013
Wiley Subscription Services, Inc
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Abstract Introduction: Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods: We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. Results: The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. Conclusions: This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population. Muscle Nerve 47: 884–889, 2013
AbstractList Introduction: Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods: We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. Results: The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. Conclusions: This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population. Muscle Nerve 47: 884-889, 2013 [PUBLICATION ABSTRACT]
Introduction : Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods : We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. Results : The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. Conclusions : This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population. Muscle Nerve 47: 884–889, 2013
Introduction: Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods: We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. Results: The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. Conclusions: This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population. Muscle Nerve 47: 884-889, 2013
Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure.INTRODUCTIONReal time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure.We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history.METHODSWe measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history.The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history.RESULTSThe lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history.This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population.CONCLUSIONSThis study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population.
Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population.
Author Sorenson, Eric J.
Watson, James C.
Strommen, Jeffrey A.
Harper, Caitlin J.
Boon, Andrea J.
Ghahfarokhi, Leili Shahgholi
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– sequence: 2
  givenname: Caitlin J.
  surname: Harper
  fullname: Harper, Caitlin J.
  organization: Mayo Medical School, Minnesota, Rochester, USA
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  givenname: Leili Shahgholi
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  fullname: Ghahfarokhi, Leili Shahgholi
  organization: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA
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  givenname: Jeffrey A.
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  fullname: Strommen, Jeffrey A.
  organization: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA
– sequence: 5
  givenname: James C.
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  organization: Department of Neurology, Mayo Clinic, Minnesota, Rochester, USA
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  givenname: Eric J.
  surname: Sorenson
  fullname: Sorenson, Eric J.
  organization: Department of Neurology, Mayo Clinic, Minnesota, Rochester, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/23625789$$D View this record in MEDLINE/PubMed
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References O'Brien PC, Dyck PJ. Procedures for setting normal values. Neurology 1995;45:17-23.
McCool FD, Tzelepis GE. Dysfunction of the diaphragm. N Engl J Med 2012;366:932-942.
Urvoas E, Pariente D, Fausser C, Lipsich J, Taleb R, Devictor D. Diaphragmatic paralysis in children: diagnosis by TM-mode ultrasound. Pediatr Radiol 1994;24:564-568.
Cohen WN. B-scan ultrasonography of abdominal mass lesions. Radiology 1969;93:589-591.
Boon AJ, Alsharif KI, Harper CM, Smith J. Ultrasound-guided needle EMG of the diaphragm: technique description and case report. Muscle Nerve 2008;38:1623-1626.
Harris RS, Giovannetti M, Kim BK. Normal ventilatory movement of the right hemidiaphragm studied by ultrasonography and pneumotachography. Radiology 1983;146:141-144.
Houston JG, Morris AD, Howie CA, Reid JL, Mcmillan N. Technical report - quantitative assessment of diaphragmatic movement - a reproducible method using ultrasound. Clin Radiol 1992;46:405-407.
Chavhan GB, Babyn PS, Cohen RA, Langer JC. Multimodality imaging of the pediatric diaphragm: anatomy and pathologic conditions. Radiographics 2010;30:1797-1817.
Resman-Gaspersc A, Podnar S. Phrenic nerve conduction studies: technical aspects and normative data. Muscle Nerve 2008;37:36-41.
Cohn D, Benditt JO, Eveloff S, McCool FD. Diaphragm thickening during inspiration. J Appl Physiol 1997;83:291-296.
Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest 2008;133:737-743.
Gerscovich EO, Cronan M, McGahan JP, Jain K, Jones CD, McDonald C. Ultrasonographic evaluation of diaphragmatic motion. J Ultrasound Med 2001;20:597-604.
Gottesman E, McCool FD. Ultrasound evaluation of the paralyzed diaphragm. Am J Respir Crit Care Med 1997;155:1570-1574.
Mccauley RGK, Labib KB. Diaphragmatic paralysis evaluated by phrenic-nerve stimulation during fluoroscopy or real-time ultrasound. Radiology 1984;153:33-36.
Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest 2009;135:391-400.
De Bruin PF, Ueki J, Bush A, Khan Y, Watson A, Pride NB. Diaphragm thickness and inspiratory strength in patients with Duchenne muscular dystrophy. Thorax 1997;52:472-475.
Wait JL, Nahormek PA, Yost WT, Rochester DP. Diaphragmatic thickness-lung volume relationship in vivo. J Appl Physiol 1989;67:1560-1568.
Haber K, Asher WM, Freimanis AK. Echographic evaluation of diaphragmatic motion in intraabdominal diseases. Radiology 1975;114:141-144.
Bolton CF, Grand'Maison F, Parkes A, Shkrum M. Needle electromyography of the diaphragm. Muscle Nerve 1992;15:678-681.
Chen R, Collins S, Remtulla H, Parkes A, Bolton CF. Phrenic nerve conduction study in normal subjects. Muscle Nerve 1995;18:330-335.
Houston JG, Morris AD, Howie CA, Reid JL, McMillan N. Technical report: quantitative assessment of diaphragmatic movement-a reproducible method using ultrasound. Clin Radiol 1992;46:405-407.
Ueki J, De Bruin PF, Pride NB. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax 1995;50:1157-1161.
Epelman M, Navarro OM, Daneman A, Miller SF. M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol 2005;35:661-667.
Ayoub J, Cohendy R, Prioux J, Ahmaidi S, Bourgeois JM, Dauzat M, et al. Diaphragm movement before and after cholecystectomy: a sonographic study. Anesth Analg 2001;92:755-761.
2001; 92
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2009; 135
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– reference: Boon AJ, Alsharif KI, Harper CM, Smith J. Ultrasound-guided needle EMG of the diaphragm: technique description and case report. Muscle Nerve 2008;38:1623-1626.
– reference: O'Brien PC, Dyck PJ. Procedures for setting normal values. Neurology 1995;45:17-23.
– reference: Cohen WN. B-scan ultrasonography of abdominal mass lesions. Radiology 1969;93:589-591.
– reference: Mccauley RGK, Labib KB. Diaphragmatic paralysis evaluated by phrenic-nerve stimulation during fluoroscopy or real-time ultrasound. Radiology 1984;153:33-36.
– reference: Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest 2008;133:737-743.
– reference: De Bruin PF, Ueki J, Bush A, Khan Y, Watson A, Pride NB. Diaphragm thickness and inspiratory strength in patients with Duchenne muscular dystrophy. Thorax 1997;52:472-475.
– reference: Houston JG, Morris AD, Howie CA, Reid JL, McMillan N. Technical report: quantitative assessment of diaphragmatic movement-a reproducible method using ultrasound. Clin Radiol 1992;46:405-407.
– reference: Chen R, Collins S, Remtulla H, Parkes A, Bolton CF. Phrenic nerve conduction study in normal subjects. Muscle Nerve 1995;18:330-335.
– reference: Wait JL, Nahormek PA, Yost WT, Rochester DP. Diaphragmatic thickness-lung volume relationship in vivo. J Appl Physiol 1989;67:1560-1568.
– reference: Houston JG, Morris AD, Howie CA, Reid JL, Mcmillan N. Technical report - quantitative assessment of diaphragmatic movement - a reproducible method using ultrasound. Clin Radiol 1992;46:405-407.
– reference: Bolton CF, Grand'Maison F, Parkes A, Shkrum M. Needle electromyography of the diaphragm. Muscle Nerve 1992;15:678-681.
– reference: Chavhan GB, Babyn PS, Cohen RA, Langer JC. Multimodality imaging of the pediatric diaphragm: anatomy and pathologic conditions. Radiographics 2010;30:1797-1817.
– reference: Resman-Gaspersc A, Podnar S. Phrenic nerve conduction studies: technical aspects and normative data. Muscle Nerve 2008;37:36-41.
– reference: Harris RS, Giovannetti M, Kim BK. Normal ventilatory movement of the right hemidiaphragm studied by ultrasonography and pneumotachography. Radiology 1983;146:141-144.
– reference: Haber K, Asher WM, Freimanis AK. Echographic evaluation of diaphragmatic motion in intraabdominal diseases. Radiology 1975;114:141-144.
– reference: Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest 2009;135:391-400.
– reference: Ayoub J, Cohendy R, Prioux J, Ahmaidi S, Bourgeois JM, Dauzat M, et al. Diaphragm movement before and after cholecystectomy: a sonographic study. Anesth Analg 2001;92:755-761.
– reference: Gerscovich EO, Cronan M, McGahan JP, Jain K, Jones CD, McDonald C. Ultrasonographic evaluation of diaphragmatic motion. J Ultrasound Med 2001;20:597-604.
– reference: Urvoas E, Pariente D, Fausser C, Lipsich J, Taleb R, Devictor D. Diaphragmatic paralysis in children: diagnosis by TM-mode ultrasound. Pediatr Radiol 1994;24:564-568.
– reference: Epelman M, Navarro OM, Daneman A, Miller SF. M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol 2005;35:661-667.
– reference: Gottesman E, McCool FD. Ultrasound evaluation of the paralyzed diaphragm. Am J Respir Crit Care Med 1997;155:1570-1574.
– reference: Cohn D, Benditt JO, Eveloff S, McCool FD. Diaphragm thickening during inspiration. J Appl Physiol 1997;83:291-296.
– reference: McCool FD, Tzelepis GE. Dysfunction of the diaphragm. N Engl J Med 2012;366:932-942.
– volume: 114
  start-page: 141
  year: 1975
  end-page: 144
  article-title: Echographic evaluation of diaphragmatic motion in intraabdominal diseases
  publication-title: Radiology
– volume: 20
  start-page: 597
  year: 2001
  end-page: 604
  article-title: Ultrasonographic evaluation of diaphragmatic motion
  publication-title: J Ultrasound Med
– volume: 366
  start-page: 932
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  article-title: Dysfunction of the diaphragm
  publication-title: N Engl J Med
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  article-title: In vivo assessment of diaphragm contraction by ultrasound in normal subjects
  publication-title: Thorax
– volume: 67
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  publication-title: J Appl Physiol
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Snippet Introduction: Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory...
Introduction : Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory...
Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. We measured...
Introduction: Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory...
Real time ultrasound imaging of the diaphragm is an under-used tool in the evaluation of patients with unexplained dyspnea or respiratory...
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StartPage 884
SubjectTerms Adult
Age
Aged
Aged, 80 and over
Body Mass Index
diaphragm
Diaphragm - diagnostic imaging
Dyspnea - physiopathology
Female
Humans
Male
Medical research
Middle Aged
normal values
Organ Size
phrenic neuropathy
quantitative ultrasound
Reference Values
Respiration
Ultrasonic imaging
Ultrasonography
ultrasound
Young Adult
Title Two-dimensional ultrasound imaging of the diaphragm: Quantitative values in normal subjects
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