TY - JOUR
T1 - Anatomical Variation in Diaphragm Thickness Assessed with Ultrasound in Healthy Volunteers
AU - Haaksma, Mark E.
AU - van Tienhoven, Arne J.
AU - Smit, Jasper M.
AU - Heldeweg, Micah L.A.
AU - Lissenberg-Witte, Birgit I.
AU - Wennen, Myrte
AU - Jonkman, Annemijn
AU - Girbes, Armand R.J.
AU - Heunks, Leo
AU - Tuinman, Pieter R.
N1 - Publisher Copyright: © 2022 The Authors
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Ultrasonography of the diaphragm in the zone of apposition has become increasingly popular to evaluate muscle thickness and thickening fraction. However, measurements in this anatomical location are frequently hindered by factors that constrain physical accessibility or that alter diaphragm position. Therefore, other anatomical positions at the chest wall for transducer placement are used, but the variability in diaphragm thickness across the dome has not been systematically studied. The aim of this study was to evaluate anatomical variation of diaphragm thickness in 46 healthy volunteers on three ventrodorsal lines and two craniocaudal positions on these three lines. The intraclass correlation coefficient (ICC) for diaphragm thickness in the craniocaudal direction on the mid-axillary line was significantly higher than those on the posterior axillary and midclavicular lines, suggesting it had the lowest variability (ICCmidaxillary = .89, 95% confidence interval [CI]: 0.83–0.93, ICCposterior axillary = 0.74, 95% CI: 0.62–0.85, ICCmidclavicular = 0.62, 95% CI: 0.43–0.47, p < 0.05). Average diaphragm thickness was comparable on the posterior axillary and midaxillary lines and substantially larger on the midclavicular line (1.24 mm [1.06–1.47], 1.27 mm [1.10–1.42] and 2.32 [1.97–2.70], p < 0.01). We conclude that the normal diaphragm has a large variability in thickness, especially in the ventrodorsal direction. Variability in craniocaudal position is the lowest at the midaxillary line, which therefore appears to be the preferred site for diaphragm thickness measurement.
AB - Ultrasonography of the diaphragm in the zone of apposition has become increasingly popular to evaluate muscle thickness and thickening fraction. However, measurements in this anatomical location are frequently hindered by factors that constrain physical accessibility or that alter diaphragm position. Therefore, other anatomical positions at the chest wall for transducer placement are used, but the variability in diaphragm thickness across the dome has not been systematically studied. The aim of this study was to evaluate anatomical variation of diaphragm thickness in 46 healthy volunteers on three ventrodorsal lines and two craniocaudal positions on these three lines. The intraclass correlation coefficient (ICC) for diaphragm thickness in the craniocaudal direction on the mid-axillary line was significantly higher than those on the posterior axillary and midclavicular lines, suggesting it had the lowest variability (ICCmidaxillary = .89, 95% confidence interval [CI]: 0.83–0.93, ICCposterior axillary = 0.74, 95% CI: 0.62–0.85, ICCmidclavicular = 0.62, 95% CI: 0.43–0.47, p < 0.05). Average diaphragm thickness was comparable on the posterior axillary and midaxillary lines and substantially larger on the midclavicular line (1.24 mm [1.06–1.47], 1.27 mm [1.10–1.42] and 2.32 [1.97–2.70], p < 0.01). We conclude that the normal diaphragm has a large variability in thickness, especially in the ventrodorsal direction. Variability in craniocaudal position is the lowest at the midaxillary line, which therefore appears to be the preferred site for diaphragm thickness measurement.
UR - http://www.scopus.com/inward/record.url?scp=85132237217&partnerID=8YFLogxK
U2 - 10.1016/j.ultrasmedbio.2022.05.008
DO - 10.1016/j.ultrasmedbio.2022.05.008
M3 - Article
C2 - 35691733
AN - SCOPUS:85132237217
SN - 0301-5629
VL - 48
SP - 1833
EP - 1839
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
IS - 9
ER -