The echogenic layers visualized above the hepatic dome in right intercostal sagittal or oblique scanning
are usually called "diaphragmatic echo" or "diaphragmatic echo complex." We have recently encountered
four cases of intrathoracic tumors in which the right intercostal scanning failed to visualize the diaphragm
at its true position and an echogenic line was seen dorsal to the tumor. When a tumor is located cranially
to the liver, and even if an echogenic line might be visualized above the tumor by ultrasound, the
possibility of intrathoracic tumor must be taken into account. In such cases, it is necessary to observe
movement of the tumor separate from that of the liver, using real time sonography. It is also recommended
that the scanning plane be altered in order to change the angle of the ultrasound beam.