Kim Wendy, Courtier Jesse, Morin Cara, Shet Narendra, Strauch Eric, Kim Jane S
Department of Radiology, University of Maryland Medical Center, 22 S. Greene St, Baltimore, MD 21201, United States; Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115.
Department of Radiology, University of California San Francisco Benioff Children's Hospital, 1975 4th St, San Francisco, CA 94158.
Clin Imaging. 2017 May-Jun;43:158-164. doi: 10.1016/j.clinimag.2017.03.007. Epub 2017 Mar 8.
Late-presenting or recurrent diaphragmatic defects can pose a diagnostic challenge due to varying clinical presentations. Current diagnostic approaches include plain film radiograph for initial assessment, with other imaging modalities such as fluoroscopy, ultrasound, CT and MRI mainly utilized for troubleshooting. As a radiation-free modality, MRI can provide a more definitive diagnosis in particular cases due to its ability to visualize discontinuity of the diaphragm, distinguishing it from eventration. MRI can also accurately characterize hernia contents, defect location and size. We present our MRI technique and review cases of different hernia types with relevant discussion of the imaging findings and correlation with intraoperative findings. MRI can be a useful diagnostic tool in the assessment of late presenting or recurrent diaphragmatic hernias.
迟发性或复发性膈肌缺损因临床表现各异,可能带来诊断挑战。当前的诊断方法包括用普通X线平片进行初步评估,其他成像方式如荧光透视、超声、CT和MRI主要用于疑难问题的解决。作为一种无辐射的成像方式,MRI能够显示膈肌的连续性中断,与膈膨出相鉴别,因此在特定病例中能提供更确切的诊断。MRI还能准确地对疝内容物、缺损位置及大小进行特征性描述。我们展示我们的MRI技术,并回顾不同类型疝的病例,对影像表现及与术中所见的相关性进行相关讨论。MRI在评估迟发性或复发性膈肌疝时可能是一种有用的诊断工具。