A new roentgenographic method of liver size estimation on simple abdomen

ABSTRACT

It is essential to estimate the liver size in the diagnosis of liver disease. Many approaches have beenattempted in the evaluation of liver size such as measurement of length, area and volume. Among these, area andvolume measurements are accurate but complicated. So various linear measurements including Pfahler's method havebeen commonly used. But to our knowledge, there was no report about linear diameter of liver in Korean adualts. Asingeneral, larger patients are likely to have larger liver than smaller ones, it seems to be more ideal toevaluate the liver size using relative ratio rather than absolute linear diameters. The main objectives of ourinvestigation were to determine the various diameters of normal and enlarged liver and the criteria ofhepatomegaly in Korean adults using absolute and relative ments. Our cases consisted of 95 clinically normalsubjects and 51 patients suffering from liver disease and diagnosed to have hepatomegaly on abdominal palpationand simple abdomen in the Dept. of Radiology, St, Mary Hospital during the period of 6 months since Jan. 1981. Wemeasured the liver size using 3 linear diameters. And as the reference measurement, the distance from the rightmargin of the liver to the left margin of spleen was also measured. We called this “abdominal transversediameter”(ATD). The results were as follows; 1. The diameters of liver were 13.4±1.6cm, 18.4±2.4cm, 19.2±2.6cmin normal group and 18.8±3.1cm, 23.5±3.0cm, 24.2±3.2cm in hepatomegaly group using midline verticaldiameter(MIVD), maximum vertical diameter (MAVD) and diagonal diameter(DD), respectively. The difference betweentwo groups were statistically very significant in every method(p<0.01). 2. The 99% tolerance limits of liverdiameters were 13.0-13.8cm, 17.8-19.0cm, 18.5-19.9cm in normal and DD, respectively. The midpoints between theupper limit of normal group and the lower limit spectively. These points are warranted to suggest criterias ofhepatomegaly. 3. There were statistical significant difference in the ratio of each diameter to ATD between normaland hepatomegaly group (p<0.01). We called this“hepato-abdominal ratio”. The “hepato-abdominal in hepatomegalygroup using MIVD, MAVD and DD, respectively. 4. The 99% tolerance limits of “hepato-abdominal ratio” were0.43-0.45, 0.59-0.63, 0.62-0.64 in normal group and 0.60-0.62, 0.75-0.77, 0.77-0.79 in hepatomegaly group usingMAVD, MAVD and DD, respectively. The midpoints between the upper limit of normal group and the lower limit ofhepatomegaly group were 0.52, 0.69, 0.70 using MIVD, MAVD and DD, respectively. These points are alsowarranted tosuggest criterias of hepatomegaly.