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. 2014 Sep 30;83(14):1264–1270. doi: 10.1212/WNL.0000000000000841

Figure 3. Ultrasound of the diaphragm.

Figure 3

The diaphragm (D) is the 3-layered structure situated deep to the intercostal (IC) muscles that span the 2 ribs. The diaphragm muscle tissue is hypoechoic (dark) on ultrasound, and the 2 layers of connective tissue encasing the muscle (peritoneum and parietal pleura) are hyperechoic (bright) on ultrasound. (A) A normal diaphragm at end-expiration (0.29 cm thick). (B) A normal diaphragm, in the same patient, at maximal inspiration (0.6 cm thick, giving a diaphragm thickening ratio of 2.1). (C) An atrophic diaphragm (0.05 cm thick) in a patient with phrenic neuropathy. R = rib.