J Korean Soc Magn Reson Med.  1997 Dec;1(1):154-161.

Spiral Computed Tomography and Ultrasound in the Diagnosis of Experimental Diaphragmatic Rupture in the Rabbit

• Kim HH
• Jung SE
• Moon SW
• Lee BY
• Lee YJ
• Choi BG
• Lee JM
• Shinn KS

Abstract

PURPOSE: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model.
MATERIALS AND METHODS
Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MRI, and US at 1 day, 3 day, and 1 week after operation.
RESULTS
US was superior to MRI or spiral CT in diagnosis of diaphragmatic rupture(P<0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitively of MRI and spiral CT increased as the size of laceration were larger, but no statistical significant was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase. US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spinal CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05) In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05).
CONCLUSION
This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

MeSH Terms

Animals
Delayed Diagnosis
Diagnosis*
Diaphragm
Hemothorax
Hernia
Humans
Lacerations
Magnetic Resonance Imaging
Models, Animal
Mortality
Pleural Effusion
Rabbits
Rupture*
Sensitivity and Specificity
Tomography, Spiral Computed*
Ultrasonography*
Viscera