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A Computer Approach to the Prediction of Spleen Weight from Routine Films

1966; Radiological Society of North America; Volume: 86; Issue: 1 Linguagem: Inglês

10.1148/86.1.73

1527-1315

Joseph E. Whitley, C. Douglas Maynard, Alfred L. Rhyne,

Abdominal Trauma and Injuries

Plain films have for some time offered a method of estimating spleen size when the organ is visible by reason of surrounding fat, adjacent bowel gas, or radiopaque substances such as Thorotrast or calcium. When visualized on routine radiographs, the lower portion of the spleen is usually seen, but the upper half of the spleen is rarely demonstrable without special technics. This problem has limited the possible approaches to routine spleen measurement. Judging spleen size by the size of the renal outline, estimating the spleen from its width at a uniform distance above the tip, and measuring the vertical length from the midpoint of the spleen tip to its interception with the diaphragm have been proposed (2–4, 8). The difficulty of estimating spleen size by palpation is well known, and the problem of its clinical and radiographic estimation has recently been discussed by Riemenschneider and Whalen (6), who have also proposed a two-dimensional method of measurement. Rösch (7) has likewise recently discussed and beautifully illustrated the routine and special radiographic procedures which can be employed in studying this organ. In an effort to evaluate the established radiographic methods and, hopefully, to develop a better objective approach to the estimation of spleen size from routine films, autopsy records for the last three years at this institution were reviewed, and cases collected in which the spleen could be visualized on plain films of the abdomen or chest obtained within eight weeks of death. Surgical specimens of the spleen were not included because of the problem of knowing whether the arterial and venous supplies were clamped simultaneously. Methods, Materials, and Results Eighty-one cases were located in our files, which met the before-mentioned criteria, and the following parameters were measured: Length (L) was estimated by a vertical line from the tip of the spleen to the intercept with the diaphragm (Fig. 1). Width (B) of the spleen 2.5 cm above the tip. Width (W) of the spleen at the midpoint of the line L or as close to this point as this measurement can be made (Fig. 1). The patient's age, sex, height, body weight, and the splenic weight and diagnosis relative to the spleen (if abnormal) were recorded. The measurements were corrected for magnification, and the information was recorded on punch cards. Simple correlations were obtained with a 1620 IBM computer. The pertinent correlations obtained are seen in Tadle I. In the 81 cases there were 32 females and 49 males with an age range of sixteen to seventy-nine years (mainly in the fiftyfive to sixty age group). Twenty-five spleens weighed 100 to 200 g; 26 weighed 201 to 300 g; and 30 weighed more than 300 g. Discussion It is interesting to note that the smallest spleen visible in this group of adults weighed 100 g and the average weight of the normal spleens in this series was 144 g.