CTICasesDiaphragmatic Eventration
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Imaging findings
Radiographs and CT demonstrate elevation of at least the anterior portion of the right hemidiaphragm. Fluoroscopy shows that while the anterior portion of the diaphragm is elevated and lacks normal motion, the posterior portion descends quite nicely and moves appropriately with respiration, at a similar level to the left posterior diaphragm. CT reveals the elevated anterior diaphragm to be a thin, non-muscular slip, described as a tendinous structure, while the crus appears normal and not atrophied.
Key takeaways
Diaphragmatic eventration is characterized by the elevation of a portion of the diaphragm that consists of a thin, non-muscular (tendinous) sheet, rather than a fully muscular structure. Unlike phrenic nerve paralysis, eventration typically spares the posterior diaphragm, which retains normal motion, and the crus usually does not show atrophy. Fluoroscopy is helpful in distinguishing eventration from paralysis based on differential diaphragmatic motion.
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