Kashani Amir, Salehi Banafsheh, Anghesom Deborah, Kawayeh Anas M, Rouse Glenn A, Runyon Bruce A
Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.).
J Ultrasound Med. 2015 Feb;34(2):233-8. doi: 10.7863/ultra.34.2.233.
The purpose of this study was to evaluate the impact of cirrhosis etiology on spleen size as measured by sonography and computed tomography (CT).
The spleen images of 139 patients with cirrhosis secondary to alcohol abuse, hepatitis C, or nonalcoholic steatohepatitis were reviewed retrospectively. The maximum diagonal spleen length on a single sonogram and maximum spleen diameter on axial, coronal, or sagittal CT, whichever was largest, was compared among the etiologic groups.
In 127 patients who underwent sonography, the mean spleen size ± SD on sonography in the alcohol group (13.1 ± 2.5 cm) was significantly smaller than in the hepatitis C (15.0 ± 3.4 cm) and nonalcoholic steatohepatitis (15.2 ± 3.0 cm) groups (95% confidence intervals of the mean difference, 0.6 to 3.3 and 0.8 to 3.4 cm, respectively). In 87 patients who underwent CT, the mean spleen size on CT in the alcohol group (14.0 ± 2.7 cm) was smaller than in the hepatitis C (15.9 ± 3.4 cm) and nonalcoholic steatohepatitis (15.5 ± 3.6 cm) groups, but the difference was not statistically significant. The spleen sizes on both sonography and CT in 79 patients were strongly correlated (r = 0.88; P < .0001).
Spleen size in patients with cirrhosis varies by the etiology of the disease. Therefore, to apply spleen size as a diagnostic or prognostic criterion in this context, it is important to recognize that cutoff values derived from spleen size in one etiologic group may not produce the same results when extrapolated to another etiologic group.
本研究旨在评估肝硬化病因对通过超声和计算机断层扫描（CT）测量的脾脏大小的影响。
回顾性分析139例因酒精滥用、丙型肝炎或非酒精性脂肪性肝炎继发肝硬化患者的脾脏图像。比较各病因组在单个超声图像上脾脏的最大对角线长度以及轴向、冠状或矢状面CT上脾脏的最大直径（取最大者）。
在127例行超声检查的患者中，酒精组超声检查测得的脾脏平均大小±标准差（13.1±2.5 cm）显著小于丙型肝炎组（15.0±3.4 cm）和非酒精性脂肪性肝炎组（15.2±3.0 cm）（平均差异的95%置信区间分别为0.6至3.3 cm和0.8至3.4 cm）。在87例行CT检查的患者中，酒精组CT测得的脾脏平均大小（14.0±2.7 cm）小于丙型肝炎组（15.9±3.4 cm）和非酒精性脂肪性肝炎组（15.5±3.6 cm），但差异无统计学意义。79例患者的超声和CT测量的脾脏大小高度相关（r = 0.88；P <.0001）。
肝硬化患者脾脏大小因疾病病因而异。因此，在此背景下将脾脏大小作为诊断或预后标准时，重要的是要认识到从一个病因组脾脏大小得出的临界值外推到另一个病因组时可能不会产生相同结果。
