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Eur Respir J 2002; 19:225-231
Copyright ©ERS Journals Ltd 2002

Magnetic resonance analysis of abnormal diaphragmatic motion in patients with emphysema

T. Iwasawa1, S. Kagei2, T. Gotoh2, Y. Yoshiike3, K. Matsushita2, H. Kurihara4, K. Saito4 and S. Matsubara4

1 Dept of Radiology, Kanagawa Cardiovascular and Respiratory Centre, 2 Graduate School of Engineering, Yokohama National University, 3 Division of Pulmonary Medicine, Kanagawa Cardiovascular and Respiratory Centre, 4 Dept of Radiology, Yokohama City University School of Medicine, Yokohama, Japan

CORRESPONDENCE: T. Iwasawa, Dept of Radiology, Kanagawa Cardiovascular and Respiratory Centre, 6-16-1, Kanazawa-ku, Yokohama, 236-8651, Japan. Fax: 81 457864770. E-mail: tae_1_md@wb3.so-net.ne.jp

Keywords: diaphragm, emphysema, lung, magnetic resonance imaging, respiration

Received: May 5, 2000
Accepted June 26, 2001

This study was partially supported by the Cancer Research Fund of Kanagawa Prefectural Hospital and International travel grants of the Japan Society of Magnetic Resonance in Medicine.

The purpose of this study was to quantitatively evaluate paradoxical diaphragmatic motion using magnetic resonance (MR) imaging.

A total of 27 subjects were examined, including 12 normal young adults, six control individuals, and nine patients with emphysema. With subjects in the supine position, 30 sequential sagittal MR images of the entire right lung were obtained during tidal and deep slow breathing.

Diaphragmatic movement between sequential images was estimated as the displacement area and the total diaphragmatic movement in a respiratory cycle was calculated. The paradoxical motion of the diaphragm, representing the inverted movement to increase or decrease lung area, since paradoxical movement ratio (Mpr=(total paradoxical diaphragmatic movement/total diaphragmatic movement)x100), was evaluated.

In patients with emphysema, paradoxical diaphragmatic motion was observed on MR images during deep breathing. The mean Mpr in emphysematous patients during deep breathing was 10±4%, which was significantly higher than 0.5±0.2% in young adults (p<0.05), and 1.2±0.6% in aged-matched controls (p<0.05).

The present results indicate that magnetic resonance images could be used to detect paradoxical diaphragmatic motion in patients with emphysema.




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