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Ultrasonography of the spleen

Planning

Indication

Ultrasonography of the spleen is included as a general screening of the upper abdomen, or when specifically requested in the referral.

Evaluation

Size

 
Maximum length of spleen on abdominal ultrasonography.

A measurement of spleen size is a standard procedure as part of a liver exam, since splenomegaly is a sign of portal hypertension.

Suggested cutoffs are:[1][2]

  • Normal (not splenomegaly): the maximum length is less than 11 cm
  • Moderate splenomegaly: the maximum length is between 11–20 cm
  • Severe splenomegaly: the maximum length is greater than 20 cm

90% confidence intervals of maximum lengths in the normal population have lower limits between 6.4 cm (in short women) and 10.2 cm (in tall men), and upper limits between 12.0 and 14.4 cm (respectively):[3]

90% confidence interval of maximum spleen length by abdominal ultrasonography by height of the person
Height Spleen length
Women Men
155 - 159 cm 6.4 - 12 cm
160 - 164 cm 7.4 - 12.2 cm 8.9 - 11.3 cm
165 - 169 cm 7.5 - 11.9 cm 8.5 - 12.5 cm
170 - 174 cm 8.3 - 13.0 cm 8.6 - 13.1 cm
175 - 179 cm 8.1 - 12.3 cm 8.6 - 13.4 cm
180 - 184 cm 9.3 - 13.4 cm
185 - 189 cm 9.3 - 13.6 cm
190 - 194 cm 9.7 - 14.3 cm
195 - 199 cm 10.2 - 14.4 cm
Age Cutoff[4]
3 months 6.0 cm
6 months 6.5 cm
12 months 7.0 cm
2 years 8.0 cm
4 years 9.0
6 years 9.5 cm
8 years 10.0 cm
10 years 11.0 cm
12 years 11.5 cm
15 years
  • 12.0 cm
    for girls
  • 13.0 cm
    for boys

For children, the cutoffs for splenomegaly are given in this table, when measuring the greatest length of the spleen between its dome and its tip, in the coronal plane through its hilum while breathing quietly.[4]

Focal changes

If the referral mentions the spleen, it is generally appropriate to scan the volume of it for any focal changes, mainly cysts or tumors.

Report

  • Even absence of enlargement. If enlarged, state both grade (such as moderate) and maximum length in a number
  • If checked, even absence of focal changes.
See also: General notes on reporting

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Neetu Radhakrishnan. Splenomegaly. Medscape. Updated Apr. 2012 (referring the classification system to Poulin et al.
  2. Page 1964 in: Florian Lang (2009). Encyclopedia of Molecular Mechanisms of Disease . Springer Science & Business Media. ISBN 9783540671367. 
  3. Chow, Kai Uwe; Luxembourg, Beate; Seifried, Erhard; Bonig, Halvard (2016). "Spleen Size Is Significantly Influenced by Body Height and Sex: Establishment of Normal Values for Spleen Size at US with a Cohort of 1200 Healthy Individuals ". Radiology 279 (1): 306–313. doi:10.1148/radiol.2015150887. ISSN 0033-8419. 
  4. 4.0 4.1 Rosenberg, H K; Markowitz, R I; Kolberg, H; Park, C; Hubbard, A; Bellah, R D (1991). "Normal splenic size in infants and children: sonographic measurements ". American Journal of Roentgenology 157 (1): 119–121. doi:10.2214/ajr.157.1.2048509. ISSN 0361-803X.