Ultrasonic Appearance Of Diaphragmatic Muscular Slips And Liver Accessory Fissures

Objective1, Preliminary study the causes of diaphragmatic muscular slips and accessory fissures.2, To investigate the effects of age, gender, COPD and other factors on the occurrence of diaphragmatic muscular slips and accessory fissures.3, Approach ultrasonic appearance of diaphragmatic muscular slips and the accessory fissures in hepar’s surface.Materials and MethodOur observations were based on2037cases in abdomen (Must include the liver)sonography during the period of May2012to December2013in Xiangya Hospital Center South University. According to the following requirements to screening:(1)situs solitus;(2) without liver, gall bladder, diaphragm operation history;(2) without liver laceration, penetrating trauma history. A total of2037subjects match conditions.Using Aloka Prosound SSD4000, Aloka Prosound a7color Doppler ultrasonic diagnostic apparatus, abdominal probe frequency of3.5～5.0MHz. According to the conventional abdominal examination method system sequentially scanning, careful observation of intrahepatic whether or not have Banding layered stronger echo from the diaphragmatic surface run through liver parenchyma (i.e. the diaphragmatic muscular slips), if there is, record its location, number, direction, and at the same time measurement; apply of CDFI and CDE observation the distribution of blood flow signal. In line with the selected standard and at or above the age of30subjects, with pulmonary function test as the main basis, record whether or not with COPD. Finally, the subjects with diaphragmatic muscular slips to the case tracking detection, see the CT findings and operation record.ResultsAmong the2037observed cases, diaphragmatic muscular slips were found in15livers,ten females and five males, mean age79.4±9.50years.Diaphragmatic muscular slips detection rate in different gender subject were no significant;Subject50years old and younger without detection;but subject over age50,diaphragmatic muscular slips detection rate increasing with age;10cases were found in great than or equal80years.Accompany COPD detection rate over without COPD and which had aremarkable difference in statistics. In12livers a single sulcus was present while in the other three the sulci were multiple. The sulcis mean width of8.4±2.5cm, mean depth of9.1±3.6cm. All sulcis were located in the superior surface of the right lobe, going from posterosuperior towards anterior inferior; In the long axis view, diaphragmatic muscular slips ultrasonic appearance were a little strong echo strip belt which width is consistent,and the echo appears strength to interphase interval,like Palisade change;In the short axis view, its ultrasonic appearance were a little stronger echo round like tubercle under diaphragm and close to it,interior echo also strength to interphase interval.Conclusion1, Diaphragmatic muscular slips and accessory fissures were found most common in the superior right lobe, the longitudinal sonogram showed "palisade" characteristic changes.2, Mechanical stress influence the depth and width of diaphragmatic muscular slips and accessory fissures on the surface of liver.3, Diaphragmatic muscular slips and accessory incidence increases with age.4, Diaphragmatic muscular slips and accessory liver closely associated with COPD.5, Variation of the surface anatomy of the liver caused by diaphragmatic muscular slips and fissures of the liver has certain guiding value for surgical operation.