From the Guidelines
The normal spleen size is generally considered to be less than 13 cm in vertical length, as defined by the Lugano Criteria. This definition is based on the international working group consensus response evaluation criteria in lymphoma (RECIL 2017) 1. When assessing spleen size, it's essential to consider the variability in size and shape among healthy individuals.
- The spleen size can be measured in different planes, but the vertical length in the coronal image is the recommended method.
- Alternatively, the spleen vertical length can be calculated by multiplying the number of spleen slices in transverse CT views by the thickness of each slice, or by measuring splenic coronal diameter on a PET maximum intensity projection image, as suggested by the RECIL 2017 criteria 1.
- It's crucial to note that splenomegaly, or an enlarged spleen, is defined as a vertical length greater than 13 cm, which may indicate various underlying conditions, such as infections, hematologic disorders, or portal hypertension.
- In clinical practice, the spleen is usually not palpable below the left costal margin in healthy adults, and any palpability may suggest splenomegaly.
- Imaging studies like ultrasound or CT scans can provide more accurate measurements of spleen size, helping to identify potential abnormalities and guide further diagnosis and treatment.
From the Research
Normal Spleen Size
- The normal spleen size is not explicitly stated in the provided studies, but we can infer some information about spleen size from the context of splenomegaly (enlarged spleen) and its relationship to various diseases.
- A study on liver donation found that the mean spleen volume before donation was 245 cc 2.
- The same study developed a standard spleen volume (SSV) model to predict normal spleen volumes in donors before donation, which took into account factors such as age, liver volume, hemoglobin levels, and body surface area 2.
- However, it's essential to note that spleen size can vary significantly among individuals, and what constitutes a "normal" spleen size may depend on various factors, including body size and overall health.
Factors Affecting Spleen Size
- Splenomegaly can be caused by various mechanisms, including liver disease, malignancy, infection, and hematologic disorders 3, 4.
- The size of the spleen can be influenced by the presence of portal hypertension, which is often associated with liver disease 5, 6.
- In patients with cirrhosis, the degree of spleen enlargement is positively correlated with increasing portal flow volume, portal vein diameter, and variceal size 5.
Measurement of Spleen Size
- Spleen size can be measured using various imaging techniques, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) 5, 2.
- Duplex-Doppler ultrasound can be used to measure spleen size and assess splenic artery resistance index, which can help differentiate between portal hypertensive and hematological splenomegaly 5.