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American Journal of Roentgenology, Vol 151, Issue 4, 709-711
Copyright © 1988 by American Roentgen Ray Society

Articles

Diaphragmatic discontinuity associated with perihepatic ascites: a sonographic refractive artifact

WD Middleton and GL Melson

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.

Apparent discontinuity in the diaphragm frequently is seen in sonograms of the right upper quadrant in patients with perihepatic ascites. Using a fresh cadaveric liver and a linear reflector to simulate the diaphragm, we performed in vitro analysis and confirmed that the appearance of the diaphragm was artifactual; this was due to refraction of the sound beam at the interface between the liver and ascites. Knowledge of the typical sonographic appearance and location of this artifact should prevent diagnostic errors.
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Copyright © 1988 by the American Roentgen Ray Society.