Ishibashi H, Okumura Y, Higuchi N, Morioka E, Kimura H, Shirahama M, Kurokawa S, Miyanaga O
First Department of Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Clin Ultrasound. 1987 Jun;15(5):313-6. doi: 10.1002/jcu.1870150504.
Spleen size in patients with infectious mononucleosis (IM) was measured using ultrasound, and the findings were compared with data obtained in cases of acute viral hepatitis (AVH). The size was expressed as the spleen index (SI) or the product of the longitudinal and transverse diameters, expressed in cm2, of the maximum cross-sectional area of the spleen. A normal value obtained from 28 healthy individuals was 15 +/- 7 cm2. The SI (mean +/- SD) of patients with AVH and IM were 38 +/- 7 cm2 and 88 +/- 26 cm2, respectively. When the SIs were divided into five groups--grade 0 (0-25), grade I (26-50), grade II (51-75), grade III (76-100), and grade IV (100+), 83.3% of the patients with AVH were graded as Grade 0 or I, whereas 88.9% patients with IM belonged to higher grades. Splenomegaly with a SI value over 75, grade III or IV, strongly suggests IM when IM and AVH are being considered in the absence of other potential causes of splenomegaly. Because the clinical features of IM sometimes resemble those of AVH, it is often difficult to differentiate the two entities. The measurement of spleen size could be a significant supplemental aid in the diagnosis of IM in primary medicine, before clinical data can be obtained.
采用超声测量传染性单核细胞增多症（IM）患者的脾脏大小，并将结果与急性病毒性肝炎（AVH）患者的数据进行比较。脾脏大小用脾脏指数（SI）表示，即脾脏最大横截面积的纵径与横径之积，单位为cm²。从28名健康个体获得的正常值为15±7 cm²。AVH患者和IM患者的SI（均值±标准差）分别为38±7 cm²和88±26 cm²。当将SI分为五组——0级（0 - 25）、Ⅰ级（26 - 50）、Ⅱ级（51 - 75）、Ⅲ级（76 - 100）和Ⅳ级（100以上）时，83.3%的AVH患者被评为0级或Ⅰ级，而88.9%的IM患者属于更高等级。当在没有其他脾肿大潜在原因的情况下考虑IM和AVH时，SI值超过75（Ⅲ级或Ⅳ级）的脾肿大强烈提示IM。由于IM的临床特征有时与AVH相似，往往难以区分这两种疾病。在获得临床数据之前，测量脾脏大小可能是基层医疗中诊断IM的一项重要辅助手段。
