Veli ÇAĞLAR, Ozan Alper ALKOÇ, Ramazan UYGUR, Berrin TUĞTAĞ, Ömer ÖZÇAĞLAYAN

Normal dalak ile splenomegalinin karşılaştırılması ve vücut kom- pozisyonu ile ilişkileri

Amaç: Sağlıklı bireyler ile splenomegali tanısı konmuş bireyler arasında, dalak büyüklüğünün karşılaştırılması ve dalak büyüklüğü ile vücut kompozisyonu arasındaki ilişkinin belirlenmesi amaçlanmıştır. Gereç ve yöntem: Namık Kemal Üniversitesi Uygulama ve Araştırma Hastanesi Radyoloji Anabilim Dalında abdominal bilgisayarlı tomografisi (BT) çekilen 81 hasta çalışmaya alındı. Hacim ölçümleri BT görüntüleri üzerinde Cavalieri prensibi ile yapıldı. Bulgular: Çalışmamıza katılan 53 birey sağlıklı dalak yapısına sahip iken, 28 birey splenomegali tanılı idi. Normal grupta dalak hacim ortalaması 179 cm, dalak uzunluğu 10.1 cm, genişliği 7.9 cm ve kalınlığı 4.5 cm olarak bulundu. Splenomegalili grupta ise, dalak hacmi 398 cm3, uzunluğu 13.4 cm, genişliği 9.8 cm ve kalınlığı 5.5 cm bulundu. Sonuç: Normal grubun aksine, splenomegalili grupta dalak hacmi, uzunluğu, genişliği ve kalınlığı ile vücut kompozisyonuna ait parametreler arasında herhangi bir ilişki saptanamadı. Bu nedenle splenomegali, vücut kompozisyonuna bağlı olmaksızın meydana gelen patolojik bir durum olarak kabul edilmelidir. Dalak hacmi ile dalak uzunluğu ve kalınlığı arasında güçlü bir korelasyonun olduğu tespit edildi. Bu bulgu dalak uzunluğunun, normal bireylerde olduğu gibi splenomegalili grupta da dalak hacminin belirlenmesinde etkili olduğu düşüncesini destekler.

Comparison of splenomegaly and normal spleen and relationships with body composition

Objective: To compare spleen sizes between healthy individuals and individuals diagnosed with splenomegaly, and to determine the effect of body composition on spleen size. Material and methods: Computed tomography images were obtained retrospectively from Radiology Department of Namik Kemal University, Practice and Research Hospital. 81 patients included to th study. Splenic volume measurements was performed with Cavalieri principle by using abdominal CT images. Results: 53 individuals who participated in our study have normal spleen structure, while 28 individuals have splenomegaly. The mean measurements were spleen volume 179 cm3, spleen length 10.1cm, width 7.9 cm and thickness 4.5 cm for the normal group. Corresponding splenomegaly measurements were 398 cm3, 13.4 cm, 9.8 cm and 5.5 cm, respectively. Conclusion: Contrary to normal group, there was no relationship in splenomegaly between spleen volume, lenght, widht, thickness and the parameters of body composition. Therefore, splenomegaly is a pathological condition that occurs regardless of body composition. There were only a strong correlation between splenic volume and splenic length thickness. Spleen length is important determinant of the splenic volume in both the normal group and the splenomegaly.

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Lamb PM, Lund A, Kanagasabay RR, Martin A, Webb JA, Reznek RH. Spleen size: how well do linear ultrasound measurements cor- relate with three-dimensional CT volume assessments? Br J Radiol 2002;75:573-7.
Silverman S, DeNardo GL, Siegel E. Determination of spleen size by scintigraphy. Cancer Biother Radiopharm 1999;14:407-11.
Yetter EM, Acosta KB, Olson MC. Blundell K. Estimating splenic volume: sonographic measurements correlated with helical CT de- termination. AJR 2003;181:1615-20.
Konus OL, Ozdemir A, Akkaya A, et al. Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography. AJR Am J Roentgenol 1998;171:1693-8.
Loftus WK, Chow LTC, Metreweli C. Sonographic measurement of splenic length: correlation with measurement at autopsy. J Clin Ultrasound 1999;27:71-4.
Sandrasegaran K, Kwo PW, DiGirolamo D, Stockberger SM, Cum- mings OW, Kopecky KK. Measurement of liver volume using spi- ral CT and the curved line and cubic spline algorithms: reproduci- bility and interobserver variation. Abdom Imaging 1999;24:61-5.
Schiano TD, Bodian C, Schwartz ME, Glajchen N, Min AD. Accu- racy and signiŞcance of computed tomographic scan assessment of hepatic volume in patients undergoing liver transplantation. Transplantation 2000;69:545-50.
Prassopoulos P, Daskalogiannaki M, Raissaki M, Hatjidakis A, Gourtsoyiannis N. Determination of normal splenic volume on computed tomography in relation to age, gender and body habitus. Eur Radiol 1997;7:246-8.
Canan S, Sahin B, Odacı E, et al. Toplam hacim, hacim yoğunluğu ve hacim oranlarının hesaplanmasında kullanılan bir stereolojik yöntem: cavalieri prensibi. Turkiye Klin Tıp Bilim Derg 2002;22:7- 14.
Caglar V, Songur A, Yagmurca M, et al. Age-related volumetric changes in pancreas: a stereological study on computed tomograp- hy. Surg Radiol Anat 2012;34:935-41.
Bezerra AS, D'Ippolito G, Faintuch S, Szejnfeld J, Ahmed M. De- termination of splenomegaly by CT: is there a place for a single measurement? AJR 2005;184:1510-3.
Kaneko J, Sugawara Y, Matsui Y, Ohkubo T, Makuuchi M. Normal splenic volume in adults by computed tomography. Hepatogastro- enterology 2002;49:1726-7.
Kaneko J, Sugawara Y, Matsui Y, Makuuchi M. Spleen size of live donors for liver transplantation. Surg Radiol Anat 2008;30:515-8.
Harris A, Kamishima T, Hao HY. Splenic volume on computed to- mography utilizing automatically contouring software and its re- lationship with age, gender, and anthropometric parameters. Eur J Radiol 2010;75:e97-101.
Schulz HG, Christou A, Gursky S, Rother P. Computerized tomog- raphy studies of normal morphology and volumetry of parench- ymatous epigastric organs in humans. Anat Anz 1986;162:1-12.
Hoefs JC, Wang FW, Lilien DL, Walker B, Kanel G. A novel, simple method of functional spleen volume calculation by liver-spleen scan. J Nucl Med 1999;40:1745-55.
Ehimwenma O, Tagbo MT. Determination of normal dimension of the spleen by ultrasound in an endemic tropical environment. Niger Med J 2011;52:198-203.
Geraghty EM, Boone JM, Mcgahan JP, Jain K. Normal organ volu- me assessment from abdominal CT. Abdom Imaging 2004;29:482- 90.
Lackner K, Brecht G, Janson R, et al. [The value of computer to- mography in the staging of primary lymph node neoplasms (aut- hor's transl)]. Rofo 1980;132:21-30.
Prassopoulos P, Cavouras D. CT assessment of normal splenic size in children. Acta Radiol 1994;35:152-4.
Sonmez G, Onem Y, Ozturk E, et al. Effects of Altitude on Spleen Volume: Sonographic Assessment. J Clin Ultrasound 2007;35:182- 5.
Schlesinger AE, Edgar KA, Boxer LA. Volume of the spleen in children as measured on CT scans: normal standards as a function of body weight. AJR 1993;160:1107-9.
Spielman AL, DeLong DM, Kliewer MA. Sonographic evaluation of spleen size in tall healthy athletes. AJR 2005;184:45-9
Serter S, Ceylan C, Tunçyürek Ö, Örgüç Ş, Pabuçcu Y. Sonograp- hic evaluation of spleen size and prevalence of accessory spleen in a healthy male Turkish population. Turk J Hematol 2010;27:25-8.
Megremis SD, Vlachonikolis IG, Tsilimigaki AM. Spleen length in childhood with US: normal values based on age, sex, and somato- metric parameters. Radiology 2004;231:129-34.
Rosenberg HK, Markowitz RI, Kolberg H, Park C, Hubbard A, Bellah RD. Normal splenic size in infants and children: sonograp- hic measurements. AJR Am J Roentgenol 1991;157:119-21.
Niederau C, Sonnenberg A, Muller JE, Erckenbrecht JF, Scholten T, Fritsch WP. Sonographic measurements of the normal liver, spleen, pancreas, and portal vein. Radiology 1983;149:537-40.
Capaccioli L, Stecco A, Vanzi E, Brizzi E. Ultrasonographic study on the growth and dimensions of healthy children and adult or- gans. Int J Anat Embryol 2000;105:1-50.
Hosey RG, Mattacola CG, Kriss V, Armsey T, Quarles JD, Jagger J. Ultrasound assessment of spleen size in collegiate athletes. Br J Sports Med 2006;40:251-4
Loftus WK, Metreweli C. Normal splenic size in a Chinese popula- tion. J Ultrasound Med 1997;16:345-7.
Frank K, Linhart P, Kortsik C, et al. Sonographic determination of spleen size: normal dimensions in adults with a healthy spleen [in German]. Ultraschall Med 1986;7:134-7.