Assessing the relationship between liver and spleen volumes in patients with liver cirrhosis using the Cavalieri principle on cross-sectional images

Abstract

In the early stages of liver cirrhosis, hepatomegaly is observed, while in the later stages, enlargement of the spleen is observed due to shrinkage of the liver and increased pressure in the portal circulation. This study examined liver and spleen volumes and their proportional relationship to each other in healthy controls (HC) and patients with liver cirrhosis (LC) using computed tomography (CT) images. CT images of 52 LC (26 females, 26 males) and 52 HC (26 females, 26 males) aged 18 to 85 years were used. Liver and spleen volumes and spleen/liver+spleen volume ratio were calculated using the Cavalieri principle. Volume and ratio data were compared between HC and LC. In addition, volumes and ratios were evaluated according to the disease classes in patients. Liver volume was larger in LC (1488.9±502.3 cm3) than in HC (1321.8±277.1 cm3) (p=0.038). Spleen volume was also larger in LC (676.8±347.02 cm3) than in HC (249.37±101.16 cm3) (p<0.001). The spleen/liver+spleen volume ratio was higher in LC (30.75±12.22%) than in HC (15.68±5.09%) (p<0.001). There was no difference in volume ratios between LC and HC according to sex (p>0.05). Liver volumes were 1670.7 cm3, 1357.4 cm3, and 1087.3 cm3, and the spleen/liver+spleen volume ratio were 26.71%, 33.49%, and 40.26% in classes A, B, and C of LC, respectively. As the cirrhosis class progressed, liver volume decreased (p=0.010), and the spleen/liver+spleen volume ratio increased (p=0.020). Liver and spleen sizes and the spleen/liver+spleen volume ratio did not change depending on sex. These values can be used as normal value parameters independent of sex. Liver and spleen volumes and ratios were larger in LC than in HC. As the class of cirrhosis progressed, liver volume decreased, and the ratio increased. Our findings suggest that the spleen/liver+spleen volume ratio can be used to evaluate the classes of liver cirrhosis.

Keywords

• Liver
• Spleen
• Volume
• Cirrhosis
• Cavalieri principle
• Computed tomography

References

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