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Abstract
OBJECTIVES The purpose of this study was to evaluate the impact of cirrhosis etiology on spleen size as measured by sonography and computed tomography (CT). METHODS The spleen images of 139 patients with cirrhosis secondary to alcohol abuse, hepatitis C, or nonalcoholic steatohepatitis were reviewed retrospectively. The maximum diagonal spleen length on a single sonogram and maximum spleen diameter on axial, coronal, or sagittal CT, whichever was largest, was compared among the etiologic groups. RESULTS In 127 patients who underwent sonography, the mean spleen size ± SD on sonography in the alcohol group (13.1 ± 2.5 cm) was significantly smaller than in the hepatitis C (15.0 ± 3.4 cm) and nonalcoholic steatohepatitis (15.2 ± 3.0 cm) groups (95% confidence intervals of the mean difference, 0.6 to 3.3 and 0.8 to 3.4 cm, respectively). In 87 patients who underwent CT, the mean spleen size on CT in the alcohol group (14.0 ± 2.7 cm) was smaller than in the hepatitis C (15.9 ± 3.4 cm) and nonalcoholic steatohepatitis (15.5 ± 3.6 cm) groups, but the difference was not statistically significant. The spleen sizes on both sonography and CT in 79 patients were strongly correlated (r = 0.88; P < .0001). CONCLUSIONS Spleen size in patients with cirrhosis varies by the etiology of the disease. Therefore, to apply spleen size as a diagnostic or prognostic criterion in this context, it is important to recognize that cutoff values derived from spleen size in one etiologic group may not produce the same results when extrapolated to another etiologic group.
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Affiliation(s)
- Amir Kashani
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.).
| | - Banafsheh Salehi
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.)
| | - Deborah Anghesom
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.)
| | - Anas M Kawayeh
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.)
| | - Glenn A Rouse
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.)
| | - Bruce A Runyon
- Department of Medicine, Riverside County Regional Medical Center, Moreno Valley, California USA (A.K.); Department of Radiology, Loma Linda University Medical Center, Loma Linda, California USA (B.S., G.A.R.); Department of Gastroenterology and Hepatology, VA Loma Linda Medical Center, Loma Linda, California USA 92357 (D.A.); Department of Internal Medicine, Loma Linda University Medical Center, Redlands, California USA (A.M.K.); and Department of Gastroenterology and Hepatology, UCLA Medical Center, Santa Monica, California USA (B.A.R.)
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