Spleen sizing by ultrasound in polycythaemia and thrombocythaemia: comparison with SPECT

• Published in: British journal of haematology Vol. 98; no. 1; pp. 103 - 107
• Main Authors: Messinezy, M., MacDonald, L. M., Nunan, T. O., Westwood, N. B., Chinn, S., Pearson, T. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-07-1997; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Observer Variation; polycythaemia; Polycythemia - diagnostic imaging; Polycythemia - pathology; Radionuclide investigations; SPECT; Spleen - diagnostic imaging; Spleen - pathology; spleen size; Splenomegaly - diagnostic imaging; Splenomegaly - pathology; thrombocythaemia; Thrombocythemia, Essential - diagnostic imaging; Thrombocythemia, Essential - pathology; Tomography, Emission-Computed, Single-Photon; Ultrasonic investigative techniques; Ultrasonography; ultrasound; Radionuclide study; Sonography; Performance evaluation; Human; Spleen; Splenomegaly; Exploration; Hemopathy; Photon; Thrombocythemia; Myeloproliferative syndrome; Polycythemia; Volume; Echography; Diagnosis; Technique; Comparative study; Emission tomography
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1997.1552969.x

Detection of non‐palpable early splenic enlargement may aid diagnosis of primary polycythaemia (PP) and primary thrombocythaemia (PT). In this study linear spleen sizing by ultrasound has been compared with spleen volume estimation by single photon emission computerized tomography (SPECT) in 26 patients. Spleen length by ultrasound correlated well with SPECT volume estimation.
Ultrasound spleen length was also measured in 60 normal control subjects where the upper limit of the 95% reference range was 11.6 cm. Changes in spleen length with both age and body weight were substantial and overshadowed the imperfect reproducibility of this method. Therefore, interpretation of an individual's measured spleen length should be in relation to that predicted for adults of the same age and weight, particularly at the extremes of the younger, heavier patients and also the older, lighter patients.
Ultrasound spleen lengths of different patient groups (21 PP, 26 PT, 17 idiopathic erythrocytosis, 12 secondary polycythaemia, nine apparent polycythaemia) were compared both using the measured overall reference range and the differences from the values predicted for their age and weight. The comparison showed that almost all patients with PP whose spleens were not palpable had spleen lengths greater than the upper limit for the normal control group, but separation from the other patient groups was incomplete.
Detection of non‐palpable splenomegaly by ultrasound length should remain a ‘minor’ criterion amongst the ‘proposed modified diagnostic criteria’ of PP.