Three-dimensional reconstruction of human diaphragm with the use of spiral computed tomography.

We developed a technique of diaphragm imaging by using spiral computed tomography, and we studied four normal subjects who had been previously investigated with magnetic resonance imaging (A. P. Gauthier, S. Verbanck, M. Estenne, C. Segebarth, P. T. Macklem, and M. Paiva. J. Appl. Physiol. 76: 495-506, 1994). One acquisition of 15- to 25-s duration was performed at residual volume, functional residual capacity, functional residual capacity plus one-half inspiratory capacity, and total lung capacity with the subject holding his breath and relaxing. From these acquisitions, 20 coronal and 30 sagittal images were reconstructed at each lung volume; on each image, diaphragm contour in the zone of apposition and in the dome was digitized with the software Osiris, and the digitized silhouettes were used for three-dimensional reconstruction with Matlab. Values of length and surface area for the diaphragm, the dome, and the zone of apposition were very similar to those obtained with magnetic resonance imaging. We conclude that satisfactory three-dimensional reconstruction of the in vivo diaphragm may be obtained with spiral computed tomography, allowing accurate measurements of muscle length, surface area, and shape.