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Evolving concepts in MDCT diagnosis of penetrating diaphragmatic injury

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Abstract

This article reviews current and evolving concepts in the diagnosis of penetrating diaphragmatic injury with multidetector CT (MDCT). As criteria for nonoperative management in the setting of penetrating trauma become more inclusive, confident exclusion of penetrating diaphragmatic injury (PDI) has become imperative. Diagnostic performance of MDCT for PDI has improved substantially with the use of thin sections and multiplanar reformats. Evaluation of injury trajectory in nonstandard planes using 3D post-processing software can aid in the diagnosis. Contiguous injury and transdiaphragmatic trajectory are the best predictors of PDI. Careful appraisal of the diaphragm for defects should be undertaken in all patients with thoracoabdominal penetrating trauma.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene, St, Baltimore, MD, 21201, USA

    David Dreizin, Peter J. Bergquist, Anil T. Taner, Uttam K. Bodanapally & Nikki Tirada

  2. Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital and Ryder Trauma Center, 1611 NW 12th Ave, West Wing 279, Miami, FL, 33136, USA

    Felipe Munera

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  1. David Dreizin
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  2. Peter J. Bergquist
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  3. Anil T. Taner
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  4. Uttam K. Bodanapally
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  6. Felipe Munera
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Correspondence to David Dreizin.

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Dreizin, D., Bergquist, P.J., Taner, A.T. et al. Evolving concepts in MDCT diagnosis of penetrating diaphragmatic injury. Emerg Radiol 22, 149–156 (2015). https://doi.org/10.1007/s10140-014-1257-6

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  • DOI: https://doi.org/10.1007/s10140-014-1257-6

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