CT diagnosis of diaphragm injuries

Admission supine chest radiographs are the initial and most commonly performed imaging study to evaluate the thorax following trauma. Whenever the chest radiograph is ambiguous or suggestive of a diagnosis of acute diaphragmatic injury, CT is the next study of choice since it is generally available and often used to examine other body regions of the polytraumatized patient. CT is usually diagnostic, particularly if supplemented by multiplanar reformations obtained using a thin slice thickness. Currently MR imaging is used at our trauma center to evaluate the diaphragm in patients with an indeterminate diagnosis after spiral CT. A limited MR imaging examination with T1-weighted sagittal and coronal imaging has been extremely accurate in establishing or excluding diaphragm injury.