Total and viable residual splenic volume measurement after partial splenic embolization by three-dimensional ultrasound.

Abstract

We prospectively evaluated the validity of total and viable residual splenic volume after partial splenic embolization (PSE) with three-dimensional (3D) ultrasound (US) measurement. Twenty patients with splenomegaly were included. All splenic volumes were measured with transabdominal US using virtual organ computer-aided analysis (VOCAL). The viable residual splenic volume after PSE was estimated by using contrast-enhanced (CE) US with VOCAL. The agreement of the measurements from VOCAL and computed tomography (CT) was confirmed using interclass correlation coefficients (ICCs) and Bland-Altman plots. Mean volume was 503±250ml for total spleen and 209±108ml for viable residual volume. Regarding total volume, there was a high correlation and agreement (ICCs=0.90) between 3D US and CT volumetry. Regarding viable residual volume, although there was a moderate correlation between 3D CEUS and CT volumetry, mean ICCs of 0.617 indicated poor agreement. With Bland-Altman plots, a narrow 95% limit of agreement was observed among patients with a total volume under 1000ml. The total splenic volume could be accurately estimated with 3D US. However, estimation of viable residual splenic volume should be limited in cases with total splenic volume under 1000ml.