MR-IMAGING EVALUATION OF HEMIDIAPHRAGMS IN ACUTE BLUNT TRAUMA - EXPERIENCE WITH 16 PATIENTS

OBJECTIVE. The aim of this retrospective study was to evaluate the use fulness of MR imaging in excluding or confirming the diagnosis of diap hragmatic injury after blunt trauma. MATERIALS AND METHODS. MR imaging studies were performed in 16 patients with blunt trauma and with inde terminate radiographs of the chest suspicious for but not diagnostic o f diaphragmatic injury. T1-weighted images were obtained in all patien ts, and fast gradient-echo pulse sequence images were obtained in 11 p atients. The results of all imaging studies performed before the MR im aging studies and those performed during outpatient follow-up, includi ng chest radiography and thoracoabdominal CT scanning, were reviewed f or evidence of diaphragmatic injury. Medical records were reviewed to ascertain the indications for the MR imaging studies as well as the su rgical findings and the duration of outpatient follow-up. RESULTS. MR imaging studies confirmed diaphragmatic injury in seven patients (44%) and revealed an intact diaphragm in nine (66%). In seven patients MR imaging studies were able to correctly reveal the site of the diaphrag matic tear and the abdominal viscera that herniated into the thoracic cavity. None of the nine patients with intact diaphragms on MR imaging studies had delayed presentation of a diaphragmatic rupture on outpat ient follow-up. CONCLUSION. MR imaging studies can be reliably used to diagnose or exclude injury in blunt trauma patients.