CT findings indicative of rupture include direct visualization of injury, segmental diaphragm nonvisualization, intrathoracic herniation of viscera, "collar sign," and peridiaphragmatic active contrast extravasation [11-13].
A CT scan, followed by oral iodinated contrast administration, is the best method to determine whether the sac content is intestinal and in this case to identify the intestinal type Diaphragmatic: segmental diaphragm nonvisualization, intrathoracic herniation of viscera, "collar sign," and peridiaphragmatic active contrast extravasation Giant colon Cavity filled with gas, fluid, or stool, with a diverticulum thin regular wall and no contrast enhancement except in the presence of inflammation; wall may contain calcifications in case of chronic inflammation Gastrointestinal Mass with a soft tissue density with central stromal areas of lower density if necrosis is present and tumors (GIST) occasionally appear as fluid-fluid levels.
To distinguish anterior peridiaphragmatic lymph nodes from pleural thickening along the costophrenic sulci, multiplanar imaging was used.
A paired t-test was used to determine if the measured mean SUV for anterior peridiaphragmatic and peri-IVC lymph nodes was significantly different from the combined mean SUV of lymph nodes far from the diaphragm.
The anterior peridiaphragmatic nodes were affected in all 11 patients (100%).
There was no significant statistical difference between mean FDG uptake in anterior peridiaphragmatic and peri-IVC nodal uptake (SUV, 2.3 [+ or -] 1.1) compared to combined mean FDG uptake of other high-attenuation nodal groups far from the diaphragm (SUV, 2.4 [+ or -] 1.2), with P = 0.83.
In our study, we observed that high-attenuation intrathoracic lymph nodes are common following talc pleurodesis and occur in the anterior peridiaphragmatic, paracardiac, internal mammary, and peri-IVC nodal groups, which are part of the lymphatic pathway for parietal pleural drainage .
Because all of the lymph nodes were subcentimeter, drawing ROIs and obtaining accurate attenuation values or SUVs was challenging, particularly for anterior peridiaphragmatic and peri-IVC lymph nodes, which are in regions susceptible to misregistration and volume and count averaging related to respiration.