Kleinman P K, Raptopoulos V
Radiology. 1985 May;155(2):289-93. doi: 10.1148/radiology.155.2.3983375.
A study of the anterior attachments of the respiratory diaphragm was performed using gross anatomic specimens, plain radiography, and computed tomography with multiplanar image reformatting. The anterior portions of the diaphragm are affixed to the lower six ribs and the sternum. The line of attachment of each hemidiaphragm begins at the anterior axillary line and extends cranially and medially to meet at the xiphoid process. These structures can be visualized along with contiguous pathologic subdiaphragmatic and/or infradiaphragmatic air collections. In the semierect patient, free intraabdominal air may preferentially collect in the anterior subdiaphragmatic regions rather than below the domes of the diaphragm, providing a subtle but reliable indication of pneumoperitoneum. An understanding of the normal anatomy of the anterior diaphragmatic attachments is valuable in assessing a variety of anterior paradiaphragmatic air collections.
利用大体解剖标本、普通X线摄影以及具有多平面图像重建功能的计算机断层扫描对呼吸膈肌的前部附着点进行了研究。膈肌的前部附着于下六根肋骨和胸骨。每个半侧膈肌的附着线始于腋前线，向头侧和内侧延伸，在剑突处汇合。这些结构可与相邻的膈下和/或膈下病理性积气一同显示。在半卧位患者中，腹腔内游离气体可能优先积聚在膈下前部区域而非膈肌穹窿下方，这为气腹提供了一个细微但可靠的征象。了解膈肌前部附着点的正常解剖结构对于评估各种膈前旁气肿具有重要价值。
