Echographic appearance of the right hemidiaphragm.

In a prospective evaluation of the right upper quadrant in 100 consecutive healthy subjects, three echogenic lines were visualized in the right posterior, superior, and lateral aspects of the abdomen in the region of the right hemidiaphragm in approximately 80 per cent. A retrospective review was made of the sonograms of 33 patients with right pleural effusions alone, 14 patients with ascites alone, and ten patients with combined ascites and pleural effusions. Analysis of the number of echogenic lines seen in the region of the right hemidiaphragm and their relationship to the gas reverberation artifact suggests that two of the three lines seen in scans of normal subjects represent actual structures (diaphragm--liver capsule complex and lung--visceral pleura an in-vitro model constructed to simulate the liver, diaphragm, lung, and pleural effusion support the hypothesis that the lung and not the diaphragm is the mirror of the right upper quadrant.