Reference Values of Different Height of Diaphragms in Chest Radiographs of Newborns.

Background: There are many causes affecting diaphragmatic height including normal variation and pathology. Both elevation and depression of the diaphragm imply various pathologies. In our knowledge, no previous study of newborn evaluated the different height of diaphragms. Using adult's reference value in interpretation of newborns' chest remains doubtful because of different imaging technique. Objective: To assess diaphragmatic height and measure different height of diaphragms in the chest radiographs of newborns. Material and Method: A retrospective review of chest radiographs was performed on 100 newborns (age less than 1 month) who were diagnosed of transient tachypnea of the newborn (TTNB) that had respiratory distress and abnormalities in chest radiographs disappeared. The diaphragmatic positions and different diaphragmatic height were evaluated in relation to thoracic vertebra and posterior rib. Results: Right diaphragmatic dome was positioned at 8.17+0.72 thoracic vertebral levels below the top of first thoracic vertebra and 8.28+0.78 crossing rib levels. Left diaphragmatic dome was positioned at 8.87+0.71 thoracic vertebral levels and 8.91+0.29 crossing rib levels. The different height of diaphragms was 0.70+0.34 thoracic vertebral body and 0.63+0.29 intercostal spaces. No newborn had the left diaphragmatic dome higher than the right side. Conclusion: The different diaphragmatic height in newborns is less than 1 intercostal space or 1 thoracic vertebral level. This knowledge is useful for assessment of chest radiographs.

Diagnostic performance of multidetector computed tomography (MDCT) in evaluation for peritoneal metastasis in gastric cancer.

OBJECTIVE: Determine the characteristic imaging findings and accuracy for diagnosis of peritoneal metastasis in gastric cancer by 64-slice multidetector computed tomography (MDCT). MATERIAL AND METHOD: A retrospective study was performed in 50 patients with gastric cancer who underwent 64-slice MDCT The patients were enrolled between January 2006 and March 2011. The MDCT scan ofabdomen from patients with gastric cancer was retrospectively evaluated by two gastrointestinal radiologists without knowledge of each patient s history, clinical data, and final diagnosis. Readers recorded the presence or absence of ascites, increased peritoneal fat density, peritoneal thickening or enhancement, and peritoneal nodule or mass. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of CT scan were calculated. RESULTS: Twenty-five patients from 50 patients indicated presence of peritoneal metastasis. The accuracies of 64-sliced MDCT of ascites, increased peritoneal fat density, peritoneal thickening/enhancement, and peritoneal nodule are 80.00, 80.00, 68.00, and 84.00%, respectively. CONCLUSION: The 64-slice MDCT is a non-invasive imaging method that can be used for diagnosing staging gastric cancer with carcinomatosis peritoneii. It is an important tool for further investigation and proper treatment. Peritoneal nodules, increased peritoneal fat density, ascites, and peritoneal thickening/enhancement are ancillary signs suggestive ofperitoneal carcinomatosis. However, in equivocal cases of imaging study, further investigation with laparoscopy is suggested to rule out small or miliary peritoneal metastasis.