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Review
. 2018;5(1):1-10.
doi: 10.3233/JND-170276.

Diaphragm: Pathophysiology and Ultrasound Imaging in Neuromuscular Disorders

Abdallah Fayssoil  1   2 , Anthony Behin  2 , Adam Ogna  3 , Dominique Mompoint  1 , Helge Amthor  1   4 , Bernard Clair  1 , Pascal Laforet  2   4 , Arnaud Mansart  1 , Helene Prigent  1   4 , David Orlikowski  1 , Tanya Stojkovic  2 , Stéphane Vinit  4 , Robert Carlier  1   4 , Bruno Eymard  2 , Frederic Lofaso  1   4 , Djillali Annane  1
Affiliations
Review

Diaphragm: Pathophysiology and Ultrasound Imaging in Neuromuscular Disorders

Abdallah Fayssoil et al. J Neuromuscul Dis. 2018.

Abstract

Respiratory muscles are classically involved in neuromuscular disorders, leading to a restrictive respiratory pattern. The diaphragm is the main respiratory muscle involved during inspiration. Ultrasound imaging is a noninvasive, radiation-free, accurate and safe technique allowing assessment of diaphragm anatomy and function. The authors review the pathophysiology of diaphragm in neuromuscular disorders, the methodology and indications of diaphragm ultrasound imaging as well as possible pitfalls in the interpretation of results.

Keywords: Diaphragm; neuromuscular disorders; ultrasound.

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Figures

Fig.1
Fig.1
Diaphragm M mode ultrasound imaging from an anterior subcostal view for the measurement of the hemi diaphragm motion during inspiration. Note the normal right hemi-diaphragmatic excursion reaching 66 mm during deep inspiration.
Fig.2
Fig.2
2D mode ultrasound imaging from the zone of apposition for the measurement of diaphragm thickness. The diaphragm is located beneath the intercostal muscles and we can distinguish three layers: a hypo-echogenic thick layer (diaphragm muscle) surrounded by two hyper-echogenic lines (pleural layer and peritoneal layer). Here is a reduced diaphragm thickness (1.3 mm) in a patient with Duchenne muscular dystrophy.
See this image and copyright information in PMC

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