Investigation for the development of the three-dimensional and quantitative method of evaluating diaphragmatic and chest wall motion in the upright position using a vertically opened MR system

本研究根据正常志愿者立位和仰卧位时的横隔壁和胸壁运动的结果，探讨开胸手术对肺癌患者横隔壁运动的影响。对39例胸部手术患者进行了术前、术后动态呼吸磁共振检查。动态呼吸磁共振检查在1.5T磁共振扫描机或0.5T垂直开口式磁共振扫描仪上进行。在2-5个呼吸周期内获得了40幅连续的MR图像。分别在双侧中矢状面的横隔膜顶点和肋背角1/4处测量充分吸气至呼气的时间，术后平均隔膜直径(26.1 mm)明显低于术前(40.8 mm)。另外，多叶切除患者非手术侧双侧双

Based on the results of the diaphragmatic and chest wall motion in upright and supine positions in normal volunteers, the influence of thoracic surgery on the diaphragmatic motion in patients with lung cancer was evaluated in this research term. Thirty-nine patients who had thoracic surgery underwent dynamic respiratory MR examination pre-operatively and post-operatively. Dynamic respiratory MR examination was performed on a 1.5 T MR scanner or 0.5 T vertically opened MR scanner. Forty sequential MR images were obtained during 2-5 respiration cycles The diaphragmatic excursions (D.E.) between full inspiration and expiration was measured on the points of the top of diaphragmatic dome and one-quarter from the dorsal costphrenic angle in the mid-sagittal plane on both sides.In the operated side, the post-opeartive average D.E. of the diaphragm (26.1 mm) was significantly lower than the preoperative value (40.8 mm). In addition, complimentary increase of D.E. in non-operative side was observed in patients who had lung resection of more than one lobe However, right middle lobectomy showed no significant difference of D.E. In addition, in three patients with phrenic nerve paralysis, D.E. was significantly greater (P<0.05) in the sitting position than the supine position.Respiratory dynamic MR imaging in the sitting and supine position may provide the useful information about the mechanism of abnormal diaphragmatic motion caused by various diseases.