Effect of Breath Holding on Spleen Volume Measured by Magnetic Resonance Imaging

Abstract

ObjectiveUltrasonographic studies have demonstrated transient reduction in spleen volume in relation to apnea diving. We measured spleen volume under various respiratory conditions by MR imaging to accurately determine the influence of ordinary breath holding on spleen volumetry.Materials and MethodsTwelve healthy adult volunteers were examined. Contiguous MR images of the spleen were acquired during free breathing and during respiratory manipulations, including breath holding at the end of normal expiration, breath holding at deep inspiration, and the valsalva maneuver, and spleen volume was measured from each image set based on the sum-of-areas method. Acquisition during free breathing was performed with respiratory triggering. The duration of each respiratory manipulation was 30 s, and five sets of MR images were acquired serially during each manipulation.ResultsBaseline spleen volume before respiratory manipulation was 173.0 ± 79.7 mL, and the coefficient of variance for two baseline measures was 1.4% ± 1.6%, suggesting excellent repeatability. Spleen volume decreased significantly just after the commencement of respiratory manipulation, remained constant during the manipulation, and returned to the control value 2 min after the cessation of the manipulation, irrespective of manipulation type. The percentages of volume reduction were 10.2% ± 2.9%, 10.2% ± 3.5%, and 13.3% ± 5.7% during expiration breath holding, deep-inspiration breath holding, and the valsalva maneuver, respectively, and these values did not differ significantly.ConclusionsSpleen volume is reduced during short breath-hold apnea in healthy adults. Physiological responses of the spleen to respiratory manipulations should be considered in the measurement and interpretation of spleen volume.

Dynamics of blood circulation during diving in the bottlenose dolphin (Tursiops truncatus). The role of the retia mirabilia

“…Our hypothesis may contribute to solve, at least in part, the question of oxygen needs of the cerebral tissue. The involvement of the retia would also explain why dolphins and other cetacean species have a relatively small spleen (Cozzi et al, 2017), as the retia would supply the reservoir of blood given by the spleen to breath-holding seals and humans during prolonged dives (Hurford et al, 1996;Inoue et al, 2013). Here, we add that dolphins lack certain components of the coagulation cascade (Semba et al, 1998;Tibbs et al, 2005), a protective factor against decompression sickness.…”

Responses of the human spleen to exercise

“…Although a few smallscale early studies based on changes in haemoglobin and haematocrit found no change in volumes of the human spleen with exercise (Dill, Talbott, & Edwards, 1930;Ebert & Stead, 1941), at least nine more recent studies of maximal effort (Agostoni et al, 1999;Allsop et al, 1992;Flamm et al, 1990;Froelich, Strauss, Moore, & McKusick, 1988;Laub et al, 1993;Lodin-Sundström, Schagatay, Schagatay, & Engan, 2014;Otto, Rona du Toit, Pretorius, Lötter, & van Aswegen, 1995;Sandler et al, 1984), mostly using the more precise technologies of technetium scintigraphy or ultrasound, found splenic contractions of 11-66% (average 42%), with a corresponding increase in circulating red blood cell volumes. Decreases of splenic volume have also been observed with various forms of apnoea (Baković et al, 2005;Baković, Valic, Eterović, Vukovic, Obad et al, 2003;Espersen, Frandsen, Lorentzen, Kanstrup, & Christensen, 2002;Hurford et al, 1990;Inoue, Nakajima, Mizukami, & Hata, 2013;Lodin-Sundström & Schagatay, 2010;Palada et al, 2007;Prommer et al, 2007;Richardson et al, 2005;Schagatay, Andersson, Hallen, & Pålsson, 2001;Schagatay, Haughey, & Reimers, 2005) (Table I), hypoxia (Lodin-Sundström & Schagatay, 2010;Richardson, Lodin, Reimers, & Schagatay, 2008), infusion of adrenaline (Baković, Pivac, Zubin Maslov, Breskovic, & Damonja et al, 2013;Knecht, Jost, Gmür, Burger, & Fehr, 1988), drowning (probably a response to a combination of hypoxia and cooling) (Haffner, Graw, & Erdelkamp, 1994) and splenic nerve stimulation (a very much smaller response than seen in horses) (Ayers et al, 1972), with changes in total red cell volume abolished by splenec...…”

Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population

“… 3 , 7 Ultrasonography is the first imaging method to assess splenomegaly. 8 , 9 It is a non-invasive, commonly available, and an affordable imaging method without the risk of ionizing radiation. Current knowledge of spleen size is based on different populations or derived from autopsy studies.…”