Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician

BackgroundThis study aimed to establish normal reference values for multimodal diaphragmatic ultrasound indices in healthy adult volunteers and evaluate intra-and inter-observer consistency between ultrasound physicians and critical care physicians.MethodsAn ultrasound physician (US physician) used...

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Main Authors: Haotian Zhao, Ling Long, Yi Liu, Yaru Yan, Xiaona Wang, Heling Zhao, Li Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1542979/full
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author Haotian Zhao
Ling Long
Yi Liu
Yaru Yan
Xiaona Wang
Heling Zhao
Li Li
author_facet Haotian Zhao
Ling Long
Yi Liu
Yaru Yan
Xiaona Wang
Heling Zhao
Li Li
author_sort Haotian Zhao
collection DOAJ
description BackgroundThis study aimed to establish normal reference values for multimodal diaphragmatic ultrasound indices in healthy adult volunteers and evaluate intra-and inter-observer consistency between ultrasound physicians and critical care physicians.MethodsAn ultrasound physician (US physician) used techniques such as B-mode, M-mode, Tissue Doppler Imaging (TDI), and shear wave elastography (SWE) to measure diaphragmatic parameters in 46 healthy adults during quiet and deep breathing. A critical care physician (CC physician) trained in diaphragmatic ultrasound repeated these measurements. Consistency was analyzed in intra-researcher and inter-researchers of various diaphragmatic ultrasound indicators.ResultsDiaphragm thickness at the end of expiration, end of inspiration, and end of deep inspiration (DT-ee, DT-ei, and DT-edi) in both B-mode and M-mode method of males were higher than that of females, Diaphragm shear modulus-edi of males is higher than that of females (P<0.05). Between different diaphragmatic ultrasound indicators, the study showed a moderate consistency of peak contraction velocity (PCV) and peak relaxation velocity (PRV) in intra-researcher of CC physician and inter-researchers between US physician and CC physician, (ICC = 0.678 and 0.704, P < 0.001). For other multiple diaphragm ultrasound indicators, our study showed an excellent consistency in both intra-researcher and inter-researchers (ICC = 0.824–0.994, P < 0.001). For DT measurement by B-mode and M-mode, it showed an excellent consistency in both intra-researcher, intra-researcher of US physician, intra-researcher of CC physician and total cases (ICC = 0.919–0.960, P < 0.001). Correlation analysis showed a moderate positive correlation between diaphragm displacement during quiet breathing (DD-qb) and pleural sliding displacement (PSD) in US physician (r = 0.568), CC physician (r = 0.470), and total cases (r = 0.511), with significant differences (P < 0.05).ConclusionUltrasound-based assessment of diaphragmatic function is a reliable method. This study provides normal reference values and highlights the high observer reproducibility among experienced ultrasound and critical care physicians.
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spelling doaj-art-a0fb4d1a8a2d4e3ebfbe6ab16af3214d2025-08-20T03:06:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15429791542979Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physicianHaotian Zhao0Ling Long1Yi Liu2Yaru Yan3Xiaona Wang4Heling Zhao5Li Li6Department of Ultrasound, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Intensive Care Unit, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Ultrasound, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Ultrasound, Shijiazhuang People’ Hospital, Shijiazhuang, ChinaDepartment of Ultrasound, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Intensive Care Unit, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Ultrasound, Hebei General Hospital, Shijiazhuang, ChinaBackgroundThis study aimed to establish normal reference values for multimodal diaphragmatic ultrasound indices in healthy adult volunteers and evaluate intra-and inter-observer consistency between ultrasound physicians and critical care physicians.MethodsAn ultrasound physician (US physician) used techniques such as B-mode, M-mode, Tissue Doppler Imaging (TDI), and shear wave elastography (SWE) to measure diaphragmatic parameters in 46 healthy adults during quiet and deep breathing. A critical care physician (CC physician) trained in diaphragmatic ultrasound repeated these measurements. Consistency was analyzed in intra-researcher and inter-researchers of various diaphragmatic ultrasound indicators.ResultsDiaphragm thickness at the end of expiration, end of inspiration, and end of deep inspiration (DT-ee, DT-ei, and DT-edi) in both B-mode and M-mode method of males were higher than that of females, Diaphragm shear modulus-edi of males is higher than that of females (P<0.05). Between different diaphragmatic ultrasound indicators, the study showed a moderate consistency of peak contraction velocity (PCV) and peak relaxation velocity (PRV) in intra-researcher of CC physician and inter-researchers between US physician and CC physician, (ICC = 0.678 and 0.704, P < 0.001). For other multiple diaphragm ultrasound indicators, our study showed an excellent consistency in both intra-researcher and inter-researchers (ICC = 0.824–0.994, P < 0.001). For DT measurement by B-mode and M-mode, it showed an excellent consistency in both intra-researcher, intra-researcher of US physician, intra-researcher of CC physician and total cases (ICC = 0.919–0.960, P < 0.001). Correlation analysis showed a moderate positive correlation between diaphragm displacement during quiet breathing (DD-qb) and pleural sliding displacement (PSD) in US physician (r = 0.568), CC physician (r = 0.470), and total cases (r = 0.511), with significant differences (P < 0.05).ConclusionUltrasound-based assessment of diaphragmatic function is a reliable method. This study provides normal reference values and highlights the high observer reproducibility among experienced ultrasound and critical care physicians.https://www.frontiersin.org/articles/10.3389/fmed.2025.1542979/fulldiaphragmatic functionultrasound examinationshear wave elastographynormal valueshealthy adults
spellingShingle Haotian Zhao
Ling Long
Yi Liu
Yaru Yan
Xiaona Wang
Heling Zhao
Li Li
Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
Frontiers in Medicine
diaphragmatic function
ultrasound examination
shear wave elastography
normal values
healthy adults
title Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
title_full Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
title_fullStr Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
title_full_unstemmed Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
title_short Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician
title_sort multimodal diaphragmatic ultrasound indicators in healthy adults reliability and consistency observation by ultrasound physician and critical care physician
topic diaphragmatic function
ultrasound examination
shear wave elastography
normal values
healthy adults
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1542979/full
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