Nuffer Zachary, Marini Thomas, Rupasov Andrey, Kwak Stephen, Bhatt Shweta
Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642.
University of Rochester School of Medicine and Dentistry, Rochester, New York.
Acad Radiol. 2017 Dec;24(12):1510-1516. doi: 10.1016/j.acra.2017.06.006. Epub 2017 Aug 8.
There is little agreement within the radiology literature as to the best single measurement for assessing splenomegaly. In this study, we evaluate the correlation of multiple unidirectional measurements of the spleen with splenic volume in patients with cirrhotic liver morphology on computed tomography (CT).
Splenic volume was retrospectively calculated from CT examinations of 179 adult patients, 47 of whom were approved as renal donors, and 132 of whom were referred for various other indications, and were found to have cirrhotic liver morphology on CT. Seven unidimensional measurements (long-axis, cranial-caudal, width, and four measures of thickness) of each spleen were evaluated to identify which most closely correlated with the calculated volume.
The splenic width had the best correlation with splenic volume for mild-to-moderate splenomegaly, and the splenic cranial-caudal measurement had the best correlation with splenic volume for massive splenomegaly. Receiver operating characteristic analysis demonstrates that a splenic width measurement of approximately 10.5 cm has a sensitivity of 89% and a specificity of 78% for mild-to-moderate splenomegaly, and a cranial-caudal measurement of 14.6 cm has a sensitivity of 92% and a specificity of 91% for massive splenomegaly.
A splenic width threshold of 10.5 cm is the most sensitive (89%) and specific (78%) single measurement for mild-to-moderate splenomegaly in patients with cirrhotic liver morphology, whereas a cranial-caudal height threshold of 14.6 cm is the most sensitive (92%) and specific (91%) single measurement for massive splenomegaly.
放射学文献中对于评估脾肿大的最佳单一测量方法几乎没有达成共识。在本研究中，我们评估了肝硬化肝脏形态的患者在计算机断层扫描（CT）上脾脏的多个单向测量值与脾体积之间的相关性。
对179例成年患者的CT检查进行回顾性计算脾体积，其中47例被批准为肾供体，132例因各种其他指征就诊，且CT检查发现有肝硬化肝脏形态。对每个脾脏的七个一维测量值（长轴、头-尾径、宽度和四个厚度测量值）进行评估，以确定哪个与计算出的体积最密切相关。
对于轻度至中度脾肿大，脾脏宽度与脾体积的相关性最佳；对于重度脾肿大，脾脏头-尾径测量值与脾体积的相关性最佳。受试者操作特征分析表明，脾脏宽度测量值约10.5 cm时，对于轻度至中度脾肿大的敏感性为89%，特异性为78%；头-尾径测量值为14.6 cm时，对于重度脾肿大的敏感性为92%，特异性为91%。
脾脏宽度阈值10.5 cm是肝硬化肝脏形态患者轻度至中度脾肿大最敏感（89%）和特异（78%）的单一测量值，而头-尾径高度阈值14.6 cm是重度脾肿大最敏感（92%）和特异（91%）的单一测量值。
