CTICasesDiaphragmatic Eventration
Imaging findings
Chest radiographs show elevated bilateral hemidiaphragms with a steep posterior descent on the lateral view. Axial CT demonstrates thinning of the diaphragmatic crura with partially intact muscle. Frontal and lateral fluoroscopy show minimal excursion of the anterior diaphragmatic dome but vigorous, normal orthograde excursion of the posterior diaphragm and posterior lung vessels during deep inspiration.
Key takeaways
Lateral fluoroscopy is highly useful in differentiating diaphragmatic eventration from true diaphragmatic paralysis. Eventration typically involves localized thinning of the anterior dome with preserved, vigorous orthograde contraction of the posterior muscular portion, whereas true paralysis demonstrates a shallow arc posteriorly and lacks vigorous orthograde posterior excursion.
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