Importance of diaphragm thickness in amyotrophic lateral sclerosis patients with diaphragm pacing system implantation

Şanli, Aydın; Şengün, İhsan Şükrü; Tertemiz, Kemal Can; Alpaydın, Aylin Özgen; Karaçam, Volkan; Şanlı, Bahar Ağaoğlu; Öz, Didem; Özalevli, Sevgi; Özdemır, Nezıh

doi:10.1007/s00464-015-4175-0

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…There are only a few studies on DT evaluation in CT (2-5). Sanli et al (2) found that DT is an important feature in patients with ALS in whom diaphragm pacing system implantation is planned. In their study, a single observer measured DT at the level of thoracic 11-12 vertebra corpus on coronal images.…”

Section: Discussionmentioning

confidence: 99%

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Diaphragm Thickness Measurement in Computed Tomography: Intra- and Inter-Observer Agreement

Ufuk¹,

Çakmak²,

Sağtaş³

et al. 2019

Istanbul Med J

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Introduction: Diaphragm thickness (DT) measurement in computed tomography (CT) has become popular in recent years. Our aim was to assess the intra-and inter-observer agreement of DT measurement and to investigate the best points for DT assessment in CT based on the most reliable measurement. Methods: Thoraco-abdominal CT angiography scans of 44 patients (23 males, mean age: 49.9±17.8 years) were retrospectively evaluated. All of the CT images were evaluated independently by four radiologists. Each observer evaluated images twice to assess intra-observer reproducibility. On both axial and coronal reconstructed CT images, the crura of 88 hemidiaphragms were measured at five different points. A p value less than 0.05 was considered to indicate statistical significance. Intra-and inter-observer agreement was evaluated by using intraclass correlation coefficient (ICC) scores with a 95% confidence interval. Results: In intra-observer analysis, ICC scores demonstrated substantial to almost perfect agreement for all measurements (ICC score range: 0.758-1). When we analyzed the inter-observer agreement, there was a moderate to almost perfect agreement for each measurement point (ICC score range: 0.523-0.895). All axial measurements showed the highest inter-observer agreement (ICC scores were 0.926 and 0.886 for first and second measurements, respectively). The maximum inter-and intra-observer agreement for single point DT measurements were found in maximum DT at the level of the origin of the celiac artery and in anterior DT at the level of the upper part of the L1 vertebral body. Conclusion: CT is a reliable tool DT measurement with excellent intra-and inter-observer agreement.

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Section: Discussionmentioning

confidence: 99%

“…The location specified for DT measurement is not a specific point and represents a very large area for DT measurement. In addition, they did not specify the CT slice thickness used in the study (2). Lee et al (3) demonstrated that DT decreased in patients who underwent mechanical-ventilation therapy in CT.…”

Section: Discussionmentioning

confidence: 99%

Diaphragm Thickness Measurement in Computed Tomography: Intra- and Inter-Observer Agreement

Ufuk¹,

Çakmak²,

Sağtaş³

et al. 2019

Istanbul Med J

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“…Firstly, a line was drawn through the anterior border of the spinal canal at T11 to L1 vertebral body level. Vertebral body level on which posteromedial diaphragm is distinguishable from adjacent solid organs and shows uniform thickness was selected 40 , 41 . The software automatically displayed intersection points of the line and diaphragm on coronal images.…”

Section: Methodsmentioning

confidence: 99%

CT-derived 3D-diaphragm motion in emphysema and IPF compared to normal subjects

Kang

Choi

Chae

et al. 2021

Sci Rep

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Image registration-based local displacement analysis enables evaluation of respiratory motion between two computed tomography-captured lung volumes. The objective of this study was to compare diaphragm movement among emphysema, idiopathic pulmonary fibrosis (IPF) and normal subjects. 29 normal, 50 emphysema, and 51 IPF subjects were included. A mass preserving image registration technique was used to compute displacement vectors of local lung regions at an acinar scale. Movement of the diaphragm was assumed to be equivalent to movement of the basal lung within 5 mm from the diaphragm. Magnitudes and directions of displacement vectors were compared between the groups. Three-dimensional (3D) and apico-basal displacements were smaller in emphysema than normal subjects (P = 0.003, P = 0.002). Low lung attenuation area on expiration scan showed significant correlations with decreased 3D and apico-basal displacements (r = − 0.546, P < 0.0001; r = − 0.521, P < 0.0001) in emphysema patients. Dorsal–ventral displacement was smaller in IPF than normal subjects (P < 0.0001). The standard deviation of the displacement angle was greater in both emphysema and IPF patients than normal subjects (P < 0.0001). In conclusion, apico-basal movement of the diaphragm is reduced in emphysema while dorsal–ventral movement is reduced in IPF. Image registration technique to multi-volume CT scans provides insight into the pathophysiology of limited diaphragmatic motion in emphysema and IPF.

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“…However, in the literature, there are only a limited number of CT-based studies investigating DT. In one of these studies, the success of the diaphragm pacing system in amyotrophic lateral sclerosis was evaluated [ 13 ]. In another CT study, it was determined that a lower DT loss during MV was a protective factor for reintubation and mortality [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Association of diaphragm thickness and density measured on chest CT with disease severity in COVID-19 patients

Parlak

Beşler²,

Gökhan³

2022

The American Journal of Emergency Medicine

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Importance of diaphragm thickness in amyotrophic lateral sclerosis patients with diaphragm pacing system implantation

Abstract: Diaphragm thickness is an important criterion in cases for which DPS implantation is planned. We consider that avoidance of DPS implantation is more suitable for cases with a diaphragm thickness below 3.50 mm because of mortality.

Cited by 8 publications

References 14 publications

Diaphragm Thickness Measurement in Computed Tomography: Intra- and Inter-Observer Agreement

Diaphragm Thickness Measurement in Computed Tomography: Intra- and Inter-Observer Agreement

CT-derived 3D-diaphragm motion in emphysema and IPF compared to normal subjects

Association of diaphragm thickness and density measured on chest CT with disease severity in COVID-19 patients

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