CTICasesDiaphragmatic Hypertrophy due to Obstructive Sleep Apnea
Imaging findings
Chest CT of an obese patient shows profound, symmetric thickening and hypertrophy of the diaphragm. The hypertrophy is highly conspicuous along the posterior diaphragmatic crura and the anterior diaphragmatic segments on sagittal and coronal reconstructions. Atrophy of the chest wall and paraspinal muscles is also observed.
Key takeaways
Severe, isolated hypertrophy of the diaphragm can develop as a physiologic response to obstructive sleep apnea or loading against an obstructed upper airway. As the patient repeatedly attempts to inspire against an occluded airway, the diaphragm performs heavy resistive work, leading to substantial muscular hypertrophy that is most easily appreciated on multiplanar CT reformats.
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