Ultrasound diagnosis of splenic lymphoma: ROC analysis of multidimensional splenic indices

Hess, Clemens F.; Kurtz, B; Hoffmann, W. H.; Bamberg, M.

doi:10.1259/0007-1285-66-790-859

Cited by 13 publications

(6 citation statements)

References 20 publications

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“…Measurements were performed 1, 4, 8, and 12 to 18 months after OLT, or when requested by the clinical condition of the patient. Splenic DIIs and spleen size, evaluated by sonography as longitudinal diameter, 7,8 were measured. The single measurement of the longitudinal diameter was used, as it has been shown to be sufficient to obtain a correct estimation of splenic size.…”

Section: Methodsmentioning

confidence: 99%

“…The single measurement of the longitudinal diameter was used, as it has been shown to be sufficient to obtain a correct estimation of splenic size. 7,8 Complications able to impair portal resistance and disorders of the normal evolution were also recorded. The presence of acute rejection was considered as a complication impairing portal resistance only if histological degree was moderate or serious (2nd and 3rd degree).…”

Section: Methodsmentioning

confidence: 99%

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Splenic impedance indices: A useful method to monitor patients after liver transplantation?

Bolognesi¹,

Sacerdoti²,

Bombonato³

et al. 1998

Hepatology

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Splenic Doppler impedance indices are influenced, in portal hypertensive patients, by the resistance of the portal system. The aim of the study was to verify the usefulness of these indices in evaluating the presence of a pathological increase in portal resistance in patients with complications after liver transplantation. Splenic impedance indices have been evaluated in 46 patients before orthotopic liver transplantation (OLT), and 2 days, 1, 4, 8, and 12 to 18 months after transplantation. The results showed that spleen size slowly decreased after liver transplantation. From a baseline longitudinal diameter value of 18.0 ؎ 3.6 cm (M ؎ SD), the decrease was by 0% ؎ 3%, 8% ؎ 8%, 13% ؎ 9%, 15% ؎ 11%, and 14% ؎ 11% at 2 days and 1, 4, 8, and 12 to 18 months after liver transplantation. Splenic impedance indices-resistance index ‫؍‬ (peak systolic ؊ end diastolic) / peak systolic velocity; pulsatility index ‫؍‬ (peak systolic ؊ end diastolic) / mean velocity-which were increased before liver transplantation, showed a rapid decrease to normal values: resistance index: from 0. The measurement of Doppler impedance indices (DIIs) is a simple and noninvasive method to evaluate alterations in arterial and venous hemodynamics associated with different pathological conditions. 1,2 These indices are mainly considered as parameters of arterial resistance, 2-4 but their interpretation varies according to the investigated organ. In particular, intra-splenic DIIs are influenced by venous congestion of the organ, as they are related to spleno-portal vascular resistance. 5 To confirm this, we have recently shown that splenic DIIs are higher on average in patients with cirrhosis and portal hypertension than in normal subjects, and they normalize after orthotopic liver transplantation (OLT). 5 The aim of the study was the evaluation of DIIs during the follow-up of patients with OLT, and of the relationships between these indices and the outcome of these patients thus establishing the clinical usefulness of the method. PATIENTS AND METHODSPatients. Forty-six patients (35 males and 11 females) with cirrhosis, who consecutively underwent OLT, were investigated. When OLT was performed, age of patients averaged 47 Ϯ 9 years (M Ϯ SD) (range 22-63). The cause of cirrhosis was alcoholic in 10 patients, posthepatitic in 23 (hepatitis B virus[HBV]-related in 7 patients, hepatitis C virus [HCV]-related in 15 patients, HBV-, HBC-, and hepatitis D virus [HDV]-related in 1 patient), mixed in 8 (HBV-related and alcoholic in 2 patients, HCV-related and alcoholic in 4 patients, HBV-and HCV-related, and alcoholic in 1 patient, HBV-and HDV-related and alcoholic in 1 patient), primary biliary in 3, secondary biliary in 2. According to Child-Pugh classification, 6 when they underwent OLT, 1 patient was class A, 31 patients were class B, and 14 were class C.All patients underwent a splanchnic duplex Doppler ultrasonography every 2 months, while they were on the waiting list for OLT. Therefore, baseline measurements were performed approxiamtely 1 month b...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Splenic impedance indices: A useful method to monitor patients after liver transplantation?

Bolognesi¹,

Sacerdoti²,

Bombonato³

et al. 1998

Hepatology

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“…CT and ultrasound criteria for involvement in normal‐sized spleen or liver included unexplained infiltrates or focal abnormalities of decreased attenuation. The spleen was considered enlarged on the CT scan, ultrasonography or SS‐R scan if the longitudinal diameter was greater than 130 mm (Hess et al , 1993; Munker et al , 1995).…”

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confidence: 99%

Somatostatin receptor scintigraphy useful in stage I–II Hodgkin's disease: more extended disease identified

Lugtenburg¹,

Krenning²,

Valkema³

et al. 2001

Br J Haematol

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Summary. Somatostatin receptor (SS-R) scintigraphy successfully shows primary cancers and metastases in patients with a variety of SS-R-positive tumours. In vitro studies have shown that SS-Rs are present in lymph nodes from patients with Hodgkin's disease (HD). We performed a prospective study in 126 newly diagnosed patients with HD and compared the results of SS-R scintigraphy with conventional staging procedures, i.e. physical examination, computerized tomography (CT) scanning and other imaging techniques. We report positive scintigraphy in all patients. The lesion-related sensitivity was 94% and varied from 98% for supradiaphragmatic lesions to 67% for infradiaphragmatic lesions. In comparison with CT scanning and ultrasonography, SS-R scintigraphy provided superior results for the detection of Hodgkin's localizations above the diaphragm. In the intra-abdominal region, the CT scan was more sensitive than the SS-R scan. A false-positive scan was rarely seen. In stages I and II supradiaphragmatic HD patients, SS-R scintigraphy detected more advanced disease in 18% (15 out of 83) of patients, resulting in an upstaging to stage III or IV, thus directly influencing patient management. Our data would support the validity of SS-R scanning as a powerful imaging technique for the staging of patients with HD.

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“…However, DISL is difficult to detect by CT or US, even though it is the most common form of splenic lymphoma (34), because DISL can manifest as a normally appearing spleen such as that with microscopic involvement only. The most frequently used parameter for the diagnosis of splenic lymphoma is splenomegaly (18). Previous studies evaluated splenic index, spleen size, and spleen weight to assess the degree of spleen enlargement (81118).…”

Section: Discussionmentioning

confidence: 99%

“…The most frequently used parameter for the diagnosis of splenic lymphoma is splenomegaly (18). Previous studies evaluated splenic index, spleen size, and spleen weight to assess the degree of spleen enlargement (81118). However, splenomegaly is not diagnostically specific.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

et al. 2016

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ObjectiveTo evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL).Materials and MethodsOne hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings.ResultsEleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively).ConclusionObliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma.

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Ultrasound diagnosis of splenic lymphoma: ROC analysis of multidimensional splenic indices

Cited by 13 publications

References 20 publications

Splenic impedance indices: A useful method to monitor patients after liver transplantation?

Splenic impedance indices: A useful method to monitor patients after liver transplantation?

Somatostatin receptor scintigraphy useful in stage I–II Hodgkin's disease: more extended disease identified

Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

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