(Ultrasound Review) Sonographic measurements of the spleen were compared with volumes established with helical CT to determine which was the best method of measurement.
Radiologists at Loyola University Medical Center in Maywood, IL, were commonly asked to assess patients for suspected splenomegaly, but were not confident about the most accurate measurement method, they wrote in the American Journal of Roentgenology.
At this institution, nuclear medicine imaging was performed for the assessment of splenic volume, however "CT is known to be a reliable and accurate method for assessing the volume of the spleen and other intraabdominal organs," according to Dr. Ellen Yetter and colleagues.
During an 18-month period, the authors compared splenic volume measurements in 117 patients. The elapsed time between CT and ultrasound examinations was never more than 30 days, and most patients had both examinations on the same day.
"Maximum length (ML) and width (W), thickness (T), and craniocaudal length (CCL) were measured sonographically," the authors wrote. Multiple sets of measurements were compared with CT volume for each patient, including standard prolate ellipsoid volume (0.524 x W x T x L) using both ML and CCL; the linear regression formula using both ML and CCL; and a new ellipsoid volume that used average length [(ML + CCL) / 2].
The authors established that "sonographic measurements allow accurate determination of splenic volume. Estimating splenic volume with the formula 0.524 x W x T x (ML + CCL)/2 provides the greatest overall accuracy."
Referring physicians soon came to expect sonographic volumes and began to routinely request this information due to the clinical usefulness, the authors stated. Calculating splenic volume added only 5-10 minutes to the examination and the authors recommended this additional measurement in patients presenting with "gastrointestinal, liver, or hematologic diseases or with suspected splenomegaly."
Estimating splenic volume: sonographic measurements correlated with helical CT determinationEllen Yetter. et. al.
Department of radiology, Loyola University Medical Center, Maywood, IL
AJR 2003 December; 181:1615-1620
By Ultrasound Review
January 19, 2004
Copyright © 2004 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
