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Ultrasound assessment of mild splenomegaly: spleen/kidney ratio
1Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N. T. Hong Kong, China.
Background:
Ultrasound may detect mild splenomegaly before it is clinically palpable. Knowledge of the normal range of spleen size in the population being examined is a prerequisite. Racial differences in splenic length could result in incorrect interpretation of splenic measurements.
Objective:
To measure the normal values of splenic length in Hong Kong Chinese children and compare the results with Western data; to determine whether there is a constant ratio of the length of the spleen to the left kidney, which could be used to diagnose splenomegaly without reference to a nomogram.
Materials And Methods:
Ultrasound was used to measure maximum splenic and left kidney length in 256 Chinese children to obtain normal values for spleen length and to determine the spleen/kidney ratio. Results. Splenic length in Chinese children is similar to Western children up to the age of about 15 years. The spleen/left kidney ratio is strikingly constant with a mean value of 1. Using 2 SD above the mean as a guide, the upper limit of normal for the spleen/kidney ratio is 1.25.
Conclusion:
Splenomegaly should be suspected in children if the spleen is more than 1.25 times longer than the adjacent kidney.