-To know the anatomy and physiology of the normal diaphragm. -To analyze the causes and complications associated with phrenic paralysis in the postoperative period of lung transplant patients. -To review the pathophysiology and clinical features of diaphragmatic paralysis, both uni as bilateral. -To review of radiological imaging techniques in the evaluation of phrenic paralysis and its main findings.

The incidence of diaphragmatic paralysis due to phrenic nerve damage following a lung transplant varies from 3 to 30%. Phrenic nerve damage is more frequent in heart-lung transplantation (incidence of 40%) than in single or bipulmonary transplantation. In the case of lung transplants, it is more frequent in the bipulmonary, with a greater involvement of the right side. The diagnosis of diaphragmatic dysfunction is important because it increases the risk of complications such as pneumonia, respiratory arrest and increases mechanical ventilation time. To evaluate and...

DIAPHRAGM ANATOMY The diaphragm is the main muscle involved in ventilation. This muscle is formed by the aponeurotic or sinewy middle part which is called "phrenic center", shaped like a three-leaf clover; a front part, rear-right one where the hiatus for the cava vein can be found, and a smaller back-left part. Around the phrenic center there's the "muscular or peripheral portion" which is inserted at multiple points in the ribcage: it inserts in the front part in the xiphisternum, the lateral edges are inserted...

Paralysis or phrenic dysfunction is a complication to be taken into account in the postoperative period of patients with lung transplantation, since it produces short-term comorbidities. The phrenic paralysis is along with primary graft dysfunction, acute lung transplant rejection and pneumonia, one of the causes that are associated with a delay in the withdrawal of mechanical ventilation, so that its diagnosis is important for proper management of the patient. To evaluate and diagnose the diaphragmatic paralysis we have several imaging techniquebeing the technique of choice...

University Hospital " Marqués de Valdecilla" Department of Radiology Avd. valdecilla s/n . 39008. Santander. Spain

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