Left hemidiaphragmatic mobility: assessment with ultrasonographic measurement of the craniocaudal displacement of the splenic hilum and the inferior pole of the spleen.

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.

Right hemidiaphragmatic mobility: assessment with US measurement of craniocaudal displacement of left branches of portal vein.

PURPOSE: To evaluate the correlation and agreement between ultrasonographic (US) measurement of craniocaudal displacement of the left intrahepatic branches of the portal vein and radiographic measurement of right hemidiaphragmatic mobility. MATERIALS AND METHODS: Fifty-one patients with indications for abdominal angiography or percutaneous cholangiography prospectively underwent radiographic evaluation of right hemidiaphragmatic mobility and B-mode US measurement of craniocaudal displacement of the left intrahepatic branches of the portal vein. US was performed by using a 3.5-MHz convex transducer in a right subcostal position with a longitudinal orientation. Statistical analyses were performed by using linear regression, paired Student t test, and Bland-Altman analyses. RESULTS: The correlation between the US and radiographic measurements was found to be linear: hemidiaphragmatic mobility = (-1.562 + 1.032) x portal vein branch displacement (r = 0.651, P <.001). The mean craniocaudal displacement of the intrahepatic branches of the portal vein measured at US was 35.2 mm +/- 10.7 (SD). The mean right hemidiaphragmatic mobility measured at radiography was 34.8 mm +/- 17.0. The mean difference between the two measurements was not statistically significant (0.4 mm +/- 12.9, P =.807). CONCLUSION: US measurement of craniocaudal displacement of the left intrahepatic branches of the portal vein can be used for indirect assessment of right hemidiaphragmatic mobility.