Evidence map›Paper›PMID 41775998›Full record

ArticleEmergency radiology2026

CT evaluation of traumatic diaphragmatic injury: a large retrospective cohort study of blunt and penetrating trauma.

Mahdi Saleh, Yigal Frank, Matias F Callejas, Yangmei Li, David Gomez, Vinu Mathew, Asutosh Sahu, Joel Kosowan, Noah Ditkofsky, Robert Moreland and 2 more

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Article in Emergency radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mahdi SalehDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Yigal FrankDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Matias F CallejasDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Yangmei LiDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
David GomezDepartment of Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Vinu MathewDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Asutosh SahuDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Joel KosowanDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Noah DitkofskyDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Robert MorelandDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Jessica RotmanDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada.
Shobhit MathurDepartment of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada. shobhit.mathur@unityhealth.to.ORCID http://orcid.org/0000-0002-7334-3341

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the diagnostic performance and interobserver agreement of CT signs for traumatic diaphragmatic injury (TDI) in a large surgically confirmed cohort, stratified by blunt and penetrating mechanisms.

methodsThis retrospective study included 106 patients with surgically confirmed TDI (38 blunt, 68 penetrating) who underwent preoperative multidetector CT between 2010 and 2022 at a level 1 trauma center. A matched control group comprised 107 patients with surgically confirmed intact diaphragms. Two blinded radiologists independently reviewed randomized CT examinations, assessing predefined direct and indirect signs: diaphragm discontinuity, intrathoracic herniation, focal thickening, dependent viscera, collar sign, and trajectory of injury (penetrating only). Interobserver agreement was measured with kappa statistics, and logistic regression identified independent predictors of TDI.

resultsIn blunt trauma, diaphragm discontinuity and intrathoracic herniation were the most sensitive signs (65–77%). In penetrating trauma, the trajectory sign demonstrated the highest sensitivity (89–91%), followed by diaphragm discontinuity and focal thickening (39–61%). Radiologists’ overall impression yielded sensitivities of 76–82% for blunt and 82–87% for penetrating trauma. Interobserver agreement was substantial (κ = 0.61–0.80).

conclusionDiaphragm discontinuity and intrathoracic herniation are key predictors of blunt TDI, whereas trajectory and focal thickening are most predictive in penetrating trauma. Recognition of mechanism-specific CT predictors may improve timely diagnosis and reduce morbidity from delayed repair.

Indexed as

DiaphragmMultidetector Computed TomographyTomography, X-Ray ComputedWounds, NonpenetratingWounds, PenetratingAdolescentAdultAgedContrast MediaFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityContrast MediaBlunt traumaDiaphragm discontinuityIntrathoracic herniationMultidetector CTPenetrating traumaTrajectory signTraumatic diaphragmatic injury

Identifiers

PMID41775998

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.