Hanke R
Rofo. 1978 Jul;129(1):1-12. doi: 10.1055/s-0029-1230952.
The paper considers the appearances of the contour of the diaphragm and of the normal irregularities of the diaphragm. The hitherto existing opinion of ill defined or tented diaphragmatic outlines always being the result of pleurodiaphragmatic implications in inflammatory or fibrotic processes in the basis of the lung needs to be corrected: In a great number of p.a. chest roentgenograms of healthy persons a more or less obvious ill definition or tenting of the medial part of the diaphragma can be found, caused by a variation of the pulmonary ligament characterized by its connection with the diaphragmatic pleura. Ill definition and tenting of the diaphragmatic outline caused by this variation of the pulmonary ligament are called physiological alterations, contrary to similar pathological (e.g. adhesive) ones. Only if this anatomical variation exists a pulmonary ligament can be roentgenologically visualized directly.
本文探讨了膈肌轮廓的表现以及膈肌的正常不规则情况。以往认为轮廓不清晰或呈帐篷状的膈肌总是肺部炎症或纤维化过程中胸膜膈肌受累的结果，这一观点需要修正：在大量健康人的后前位胸部X线片上，可以发现或多或少明显的膈肌内侧部分轮廓不清晰或呈帐篷状，这是由肺韧带的变异引起的，其特征是与膈胸膜相连。由肺韧带的这种变异引起的膈肌轮廓不清晰和呈帐篷状被称为生理性改变，与类似的病理性（如粘连性）改变相反。只有存在这种解剖变异时，肺韧带才能在X线片上直接显影。
