Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population

Objectives:

To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI).

Methods:

A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson’s correlation coefficient.

Results:

The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm³ in volume. Men had larger spleens than women (p<0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p<0.0001), using Pearson’s correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3.

Conclusion:

A local reference of spleen dimensions was established with a different range of values reported previously.The spleen is the largest organ in the reticulo endothelial system.1 Spleen size is important in the evaluation of gastrointestinal and hematological diseases for both radiologists and clinicians.2 A normal spleen weighs 150-200 g, and is 10.9 ± 1.4 cm long, 4.0 ± 0.45 cm deep, and 6.8 ± 0.71 cm in diameter. It is located in the left hypogastric quadrant of the abdomen beneath the 9th to the 11th intercostal spaces. It is a crescent shaped structure, with a convex outer margin, and indented inner margin.3 Splenomegaly is a well-known manifestation of several diseases that may involve the liver, immune system, and hematopoietic system.4,5 The reliability of clinical palpation is imprecise; the normal spleen is usually not palpable, whereas a non-palpable spleen is not always normal sized.6 The spleen volume can be measured by various techniques such as radiography, scintigraphy, CT, MRI, and ultrasonography.3,7 Ultrasonography is the first imaging method to assess splenomegaly.8,9 It is a non-invasive, commonly available, and an affordable imaging method without the risk of ionizing radiation. Current knowledge of spleen size is based on different populations or derived from autopsy studies.10 So far, established normal limits of spleen dimensions remain scanty in the Jordanian population, and the ultrasound data from the previous studies demonstrated that racial differences could affect the splenic volume; this necessitates the establishment of normative data of spleen dimensions for different areas.11,12The aim of this prospective pilot screening survey was to establish reference values of splenic dimensions and volume in a population of adult healthy Jordanians, and to determine the relationship of splenic volume with gender, age, body height, weight, body surface area (BSA), and body mass index (BMI). This study was conducted as a first step in an attempt to improve the study design prior to performance of a full scale investigation of splenic volumes in a Mediterranean population.