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Normal sonographic liver and spleen dimensions in a central European pediatric population
Stephan Waelti1,2,3, Tim Fischer4,5, Simon Wildermuth4,5
1Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland. stephan.waelti@kssg.ch.
Insights
Contemporary pediatric liver and spleen size charts are essential, as organ dimensions vary by ethnicity and have increased over time. This study provides updated normative ranges for a predominantly Caucasian population, highlighting gender and ethnic differences.
Area of Science:
- Pediatric imaging and organometry
- Anthropometry and growth studies
- Clinical reference standards
Background:
- Organ size is influenced by age, height, weight, and ethnicity.
- Pediatric growth patterns have evolved, necessitating updated reference data.
- Existing sonographic liver size charts for Caucasian populations are limited.
Purpose of the Study:
- To establish contemporary normative ranges for liver and spleen dimensions in pediatric populations (0-18 years).
- To investigate differences in organ size based on gender and ethnicity.
- To provide updated reference data for clinical practice.
Main Methods:
- Retrospective analysis of sonographic findings in 736 healthy children (1 day - 18.4 years).
- Measurement of liver (craniocaudal, anteroposterior) and spleen (craniocaudal) dimensions.
- Investigation of relationships between organ size and age, body length, body surface area, weight, and gender.
Main Results:
- Liver size in Central European children is larger (1-2 cm) than in non-Caucasian populations from the second year of life.
- Current liver sizes in Central European children are greater than those recorded nearly 40 years ago.
- Spleen dimensions were similar across Central European, US-American, and Turkish children; boys exhibited larger liver and spleen sizes than girls.
Conclusions:
- Updated, ethnically appropriate reference charts for pediatric liver and spleen measurements are crucial.
- Height is a more reliable reference than age for reducing ethnic variations in organ size.
- These findings have significant implications for accurate clinical assessment and diagnosis.
Background:
Organ size is influenced by a number of factors. Age, height, weight, and ethnicity are known influencing factors. Pediatric populations have changed over time, puberty beginning earlier resulting in a changing growth pattern of their organs. Hence, contemporary charts using local data are considered the most appropriate for a given population. Sonographic charts for liver size for a predominantly Caucasian population are limited, which has implications for clinical practice. The aim of this study was to define a contemporary normative range of liver and spleen sizes for a healthy, predominantly Caucasian population and for all pediatric age groups (0-18 years) and to investigate whether there is a size difference between genders and ethnicities.
Methods:
Retrospective study including children with normal sonographic findings and no evidence of liver or splenic disease clinically. Craniocaudal and anteroposterior dimensions are measured for the right and left lobe of the liver, and craniocaudal dimension for the spleen. Relationship of the liver and spleen dimensions with age, body length, body surface area, weight, and gender were investigated. Charts of normal values were established. Values were compared to studies involving other ethnicities and to one study carried out in 1983 involving the same ethnicity.
Results:
Seven hundred thirty-six children (371 boys, 365 girls) aged 1 day - 18.4 years were included. From the second year of life, the craniocaudal dimension of the right lobe of the liver is 1-2 cm larger in the Central European population compared with non-Caucasian populations at a given age. Liver size of Central European children in 2020 is greater compared to a similar population almost 40 years ago. The craniocaudal dimension of the spleen of Central European, US-American and Turkish children is similar. The difference between genders is statistically significant for both the liver and the spleen, being larger in boys.
Conclusion:
Contemporary and ethnically appropriate reference charts for liver and spleen measurements should be used, especially for liver size. The effect of ethnicity is reduced if patient height rather than age is referenced.
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