Application of image post -processing technique to measure spleen volume and evaluate the effect of orthotopic liver transplantation on relieving hypersplenism / 中华器官移植杂志

Objective To employ image post-processing technique measuring splenic volume for evaluating the mitigation effect of end-stage liver disease patients complicated with different degrees of hypersplenism undergoing orthotopic liver transplantation .Methods For 55 end-stage liver disease patients with hypersplenism undergoing orthotopic liver transplantation ,the changes in splenic volume were measured before and after transplantation by image post-processing system Advantage Workstation 46 (AW46) and the changes of splenic thickness ,portal flow velocity and platelet counts observed during perioperative period .Results Postoperative splenic volumes of 55 recipients were (562 .90 ± 49 .16) cm3 ,significantly decreased than preoperative (850 .50 ± 77 .99) cm3 (P< 0 .05) and reduction ratio was (31 .70 ± 2 .76 )％ . Splenic thickness at different postoperative timepoints was significantly lower than that pre-operation (P< 0 .05) and stabilized at 1 month post-transplantation ; Splenic volume was positively correlated with splenic thickness ( r = 0 .78 , P < 0 .05 ) . Portal flow velocity at different postoperative timepoints increased significantly as compared with preoperative ( P < 0 .05) ,peaked at (380 .70 ± 21 .80) mm/s at 1 month post-transplantation ,declined and stabilized at 3 months post-transplantation . Platelet counts (PLT ) at different postoperative timepoints were significantly higher than those at pre-operation ( P < 0 .05 ) ,peaked (193 .40 ± 10 .36 ) × 109 /L at 2 weeks post-transplantation ,dropped and remained at 2 months post-transplantation ;Splenic volume was negatively correlated with PLT ( r = -0 .44 , P < 0 .05 ) . And hypersplenism recovery rate and recurrence rate within 10 months post-transplantation was (78 .79 ± 2 .29 )％ and (17 .75 ± 2 .31 )％ respectively .Conclusions Orthotopic liver transplantation can effectively alleviate hypersplenism for most end-stage liver diseases .Using image post-processing system ,splenic volume may be calculated and blood routine and ultrasound are simultaneously used for assessing the outcomes of liver transplantation on hypersplenism .

Functional remnant liver volume to spleen volume ratio is a useful predictive factor for posthepatectomy liver dysfunction / 中华肝胆外科杂志

Objective Toidentify factors contributing to posthepatectomy liver dysfunction (PHLD),focusing on the Functional remnant liver volume to spleen volume ratio (FreLSVR).Methods The clinical data of 74 patients undergoing precise liver resection from January 2016 to October 2017 were retrospectively analyzed.IQQA liver system was used to reconstruct the liver and spleen 3D image by using patients' preoperative abdominal CT image data.Tumor volume,3D estimated functional residual liver volume,spleen volume and FreLSVR were measured and calculated.Preoperative and postoperative liver function test,blood coagulation function test,operation time,intraoperative blood loss,and the volume of daily postoperative abdominal drainage were recorded.Correlations between multiple parameters and PHLD were analyzed.Results PHLD occurred in 16 (21.6％).Single factor analysis revealed that the standardized residual liver volume ratio (P＜0.05),FreLSVR (P＜0.05) and preoperative AST value (P＜0.05) were correlated with postoperative hepatic insufficiency.Multivariate regression analysis showed that FreLSVR (OR=0.535,95％CI=0.305～0.936,P＜0.05) was the only independent factor of PHLD.In the ROC curve analysis for FreLSVR,a cut-off value of 2.56 (AUC=0.824,Sensitivity 81.1％,specificity 71.7％.) was the appropriate value for predicting the risk of PHLD according to Youden index.Then the patients were regrouped according to this cut-off value.Compared with the FreLSVR＞2.56 group (53 cases),the highest postoperative INR value (1.46± 0.19 to 1.29± 0.29,t=-2.405,P＜0.05) was higher that of FreLSVR≤2.56 group,and the amount of average daily abdominal drainage in one and two weeks after operation was higher,(188.0(79.2 ～ 375.1)ml to 96.0(46.5 ～ 179.3)ml,P＜0.05) and (207.2(125.6 ～ 827.1)ml to71.8(14.0 ～ 179.8) ml,P＜0.05),respectively.Conclusion FreLSVR has significant correlation with postoperative hepatic dysfunction,and provides guidance for the safety of liver resection in the future.

Sonographic determination of normal spleen size in Turkish adults / Determinación ecográfica del tamaño normal del bazo en adultos turcos

The current study was undertaken to determine normal spleen dimensions and anthropometric evaluation by ultrasonography from females and males in our population. These measurements were taken using an ultrasonography. The mean values of the age, height, weight and body mass index (BMI) of subjects, spleen width (SW), spleen length (SL), spleen thickness (ST) and spleen volume calculated with elipsoid formula; length x width x thickness x 0.524 were taken. These measurements were found to be 36.37±10.83 years, 164.22±4.72 cm, 60.26±7.11 kg, 22.30±2.09 kg/m2, 7.58±1.56 cm, 9.87±1.28 cm, 3.34±0.79 cm and 136.05±61.14 cm3 in females respectively. Additionally, in males same dimensions were 40.50±12.77 years, 174.41±6.57 cm, 76.33±8.54 kg, 25.06±2.10 kg/m2, 8.75±1.84 cm, 11.01±1.186 cm, 4.12±1.09 cm and 220.70±115.35 cm3 respectively. The observations presented in this report have defined anatomic parameters about spleen size that need to be taken into consideration for reference data to determine population discrepancies and helpful for radiologists and clinicians.

El objetivo fue determinar las dimensiones normales del bazo y realizar una evaluación antropométrica mediante ecografía en mujeres y hombres turcos. Fueron calculados los valores medios de edad, altura, peso, índice de masa corporal (IMC), ancho del bazo (AB), longitud del bazo (LB) y grosor del bazo (GB), junto al volumen del bazo mediante la fórmula elipsoide (largo x ancho x grosor x 0,524). Las mujeres presentaron una edad de 36,37±10,83 años, altura de 164,22±4,72 cm, peso de 60,26±7,11 kg, IMC de 22,30±2,09 kg/m2, AB de 7,58±1,56 cm, LB de 9,87±1,28 cm, GB de 3,34±0,79 cm y volumen del bazo de 136,05±61,14 cm3. Los hombres presentaron una edad de 40,50±12,77 años, altura de 174,41±6,57 cm, peso de 76,33±8,54 kg, IMC de 25,06±2,10 kg/m2, AB de 8,75±1,84 cm, LB de 11,01±1,186 cm, GB de 4,12±1,09 cm y volumen del bazo de 220,70±115,35 cm3. Nuestras observaciones han definido parámetros anatómicos sobre el tamaño del bazo, los cuales deben ser considerados como datos de referencia para determinar las discrepancias en la población, de utilidad para radiólogos y clínicos.

Comparison the diagnosis of chronic hepatic fibrosis and cirrhosis with ADC value of the liver and the liver-spleen volume ratio examined by MR / 实用放射学杂志

Objective To investigate the relationship and compare the diagnosis in chronic hepatic fibrosis and cirrhosis between liver ADC value and the liver spleen volume ratio changes by MR.Methods The obj ect included 3 1 cases of chronic hepatic fibrosis, cirrhosis and 14 cases of control group.The liver ADC value (b=800 s/mm2 )and the liver spleen volume ratio in different fibrosis stages were measured.Analysis of variances was performed to compare the difference between the two groups.Results The right lobe of liver ADC value and the liver spleen volume ratio in each group was significant (P<0.01).With the increase of fibrosis score,liver ADC was correlated negatively.From normal to mild cirrhosis (S1-S2),the total liver volume increased progressively. From severe hepatic fibrosis to advanced cirrhosis (S3-S4),it decreased slowly and spleen volume increased gradually along as cir-rhosis degree,while the liver spleen volume ratio correspondingly decreased.Area under the curve (AUC)in the group of liver ADC value was 0.789,sensitivity was 0.806,and specificity was 0.857.The group of liver spleen volume ratio AUC was 0.744,sensi-tivity was 0.742,and specificity was 0.714.Conclusion The correlation of the two methods for evaluating the effectiveness of liver fibrosis and cirrhosis are both significant.Whereas,ADC value was better for liver fibrosis,which is the best method for diagnosis of early liver fibrosis.