Andrew Grenville Taylor MD, PhD, Abstract Co-Author: Nothing to Disclose

Carlos U. Corvera MD, Abstract Co-Author: Nothing to Disclose

Tehetena Asfaw, Presenter: Nothing to Disclose

Benjamin M. Yeh MD, Abstract Co-Author: Research grant, Bayer AG

Judy Yee MD, Abstract Co-Author: Research grant, General Electric Company

Rizwan Aslam MBChB, Abstract Co-Author: Nothing to Disclose

To assess changes in splenic volume following hepatic resection, measured with thin-slice axial CT and subsequent segmentation and 3D volume rendering. 

A retrospective evaluation of spleen and liver volume was performed using segmentation and 3D volume reconstruction on both the pre- and post-operative CT scans of 10 randomly selected patients (mean age 62.6 yrs) undergoing hepatic resection for benign or malignant disease (8 due to hepatocellular carcinoma, 1 for metastatic colorectal carcinoma and 1 for a large, symptomatic hepatic cyst) between 2004 and 2009. Additionally, splenic volumes were calculated from pre- and post-operative CT scans of 10 control patients (mean age 72.2 yrs) who underwent nephrectomy between 2005 and 2010. CT scans were obtained on a 64-slice MDCT scanner and volumes were measured using Advantage Workstation software. Percent change in volume was calculated for both groups, and statistical analysis was performed using an unpaired, two-tailed t-test assuming equal variance in both groups.

Patients in the partial hepatectomy group (mean time to follow-up 93 days) demonstrated a significant (p < 0.02) mean increase in post-operative splenic volume of 24.7% (range -17.7% to +79.4%), when compared against the control nephrectomy group (mean splenic volume change -0.1%, range -39.8% to 17.7%). No significant correlation was seen between percent change in hepatic volume (average -7.4%, range -40% to +8.3%) and splenic volume change, or between the pre-operative splenic volume and subsequent splenic volume change.

Partial hepatic resection results in a significant increase in postoperative splenic volume when compared to non-hepatic organ resection such as nephrectomy. This change in splenic volume can be well assessed by thin-section MDCT with 3D volume rendering. The etiology of the volume increase requires further study and may relate to changes in portal blood flow, or to a response of the spleen to regenerative factors induced by the hepatic resection.

Splenic hypertrophy occurs after partial hepatectomy. Further, splenic factors may relate to amount of hepatic regeneration expected, and may guide patient selection and extent of hepatic resection.

Taylor, A, Corvera, C, Asfaw, T, Yeh, B, Yee, J, Aslam, R, MDCT Evaluation of Splenic Hypertrophy Following Partial Hepatectomy.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008405.html