Ultrasonido: Una alternativa en la evaluación del diafragma en ni?os con distrofia muscular de Duchenne

摘要

The outcome of children with Duchenne muscular dystrophy (DMD) depends on respiratory involvement, so a timely assessment of the diaphragm is required. We propose ultrasound (US) imaging as an alternative in the evaluation of the diaphragm in children with DMD, correlating diaphragmatic thickness and excursion values yielded by the US study with pulmonary function tests. We conducted a case-control study including 27 children, 15 controls and 12 patients. Excursion and thickness of both hemidiaphragms were measured by U.S., and spirometry was performed. The DMD group showed less excursion and a significantly higher thickness of the right hemidiaphragm; 60% of patients showed spirometric restrictive pattern and FEV1, FVC, PEF and PIM values were significantly lower. We found a negative trend when correlating diaphragmatic excursion with pulmonary function tests. We conclude that the US technique is suitable for screening alterations in diaphragmatic excursion and thickness in children with DMD, since it provides supporting data to pulmonary function tests.