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Right Hemidiaphragmatic Mobility: Assessment with US Measurement of Craniocaudal Displacement of Left Branches of Portal Vein¹

¹ From the Liver Unit (N.S.G.T., P.C.B.M., O.I.P., S.M.) and Department of Radiology (S.K.K.), University of São Paulo Medical School, Brazil. Received September 19, 2001; revision requested November 26; final revision received November 25, 2002; accepted December 19. Supported by FAPESP grant 99/10418-3. Address correspondence to N.S.G.T., R. Luxemburgo, 113-CEP, 86046-410 Londrina, Brazil (e-mail: tolecosta@hotmail.com).

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.

© RSNA, 2003

Index terms: Diaphragm, 66.12989, 66.155, 66.91 • Hepatic veins, US, 957.12989 • Liver, US, 761.12989 • Ultrasound (US), physics, 761.12989, 957.12989

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