Elstein Deborah, Tiomkin Maayan, Hadas-Halpern Irith, Zimran Ari
Shaare Zedek Medical Center, Jerusalem, Israel.
Ultrasound Q. 2011 Dec;27(4):225-8. doi: 10.1097/RUQ.0b013e318239c5eb.
Although ultrasonography (US) may be recommended for repeat assessments of spleen and liver volumes, it is less readily used than magnetic resonance imaging and computed tomography (CT) because of concerns of accuracy and reproducibility. In monitoring spleen and liver volumes for Gaucher disease where volume changes underlie management decisions, in experienced hands, US has a place because some patients are evaluated for decades and sometimes several times annually. The purpose of this survey was to ascertain whether one can maximize the efficiency of US imaging by use of one US axis if it correlates with CT-generated volumes.
A patient cohort from a large tertiary clinic dedicated to Gaucher disease was used. Thirty-seven patients with simultaneous abdominal CT and US evaluations (1992-2009), 27 (73%) at the advent of Gaucher-specific therapy, and followed both by CT and US up to 3 additional times (interval, ≥12 months) were included. Ultrasound evaluation of 3 axes, longitudinal, width, and depth, was performed by one radiologist; all organs including idiosyncratically shaped and massively enlarged organs were included.
There was a significant correlation between CT volume and US length axis for both spleen (0.619) and for liver (0.557) volumes (P = 0.01; 2-tailed for each).
With some training, the use of the longitudinal axis by US assessment may suffice to approximate estimation of changes in organ volumes.
尽管超声检查(US)可能被推荐用于脾脏和肝脏体积的重复评估,但由于对准确性和可重复性的担忧,其使用不如磁共振成像和计算机断层扫描(CT)普遍。在监测戈谢病的脾脏和肝脏体积时,体积变化是管理决策的依据,在经验丰富的医生手中,US有其用武之地,因为有些患者要接受数十年的评估,有时每年还要评估几次。本次调查的目的是确定如果US的一个轴与CT生成的体积相关,是否可以通过使用该轴来最大限度地提高US成像的效率。
使用来自一家大型三级诊所专门诊治戈谢病的患者队列。纳入了37例同时进行腹部CT和US评估的患者(1992 - 2009年),其中27例(73%)在开始接受戈谢病特异性治疗时进行评估,并随后进行CT和US检查,最多再进行3次(间隔≥12个月)。由一名放射科医生对3个轴(纵向、宽度和深度)进行超声评估;所有器官,包括形状特异和大量肿大的器官都包括在内。
脾脏(0.619)和肝脏(0.557)的CT体积与US长度轴之间均存在显著相关性(P = 0.01;均为双侧检验)。
经过一些培训,通过US评估使用纵向轴可能足以近似估计器官体积的变化。