Pediatric Radiology

, Volume 43, Issue 11, pp 1464–1474

Reference ranges for sonographic dimensions of the liver and spleen in preterm infants

Authors

  • Zelal Kahramaner
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
  • Aydin Erdemir
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
  • Ebru Cicek
    • Department of RadiologyThe Ministry of Health Tepecik Teaching and Research Hospital
  • Hese Cosar
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
  • Ebru Turkoglu
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
  • Sumer Sutcuoglu
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
    • Department of PediatricsThe Ministry of Health Tepecik Teaching and Research Hospital
Original Article

DOI: 10.1007/s00247-013-2729-7

Cite this article as:
Kahramaner, Z., Erdemir, A., Cicek, E. et al. Pediatr Radiol (2013) 43: 1464. doi:10.1007/s00247-013-2729-7
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Abstract

Background

Preterm infants usually have multiple comorbidities that affect spleen and liver. Ultrasonographic measurement of organ sizes is an important and reliable parameter in evaluation of spleen and liver pathology in preterm newborns.

Objective

The purpose of this study was to determine reference values of ultrasonographic measurements of the liver and spleen in preterm newborns.

Materials and methods

We prospectively performed sonography on 498 preterm newborns in the first week of life. We measured spleen and liver dimensions and statistically analyzed relationships between the dimensions and gender, gestational age (based on mother’s last menstrual period), height and weight. Reference ranges of dimensions were defined.

Results

Longitudinal and anteroposterior dimensions of the liver and spleen were statistically significantly different between the boys and girls (P < 0.05) and showed high correlation with the gestational age, weight and height. Weight was the parameter best correlated with the dimensions.

Conclusion

Nomograms from these data are useful for sonographic evaluation of the liver and spleen in preterm newborns.

Keywords

Preterm newbornNormal measurementLiverSpleenUltrasound

Introduction

Many diseases lead to changes in size and morphology of the liver and spleen in neonates. Preterm infants, in particular, have multiple comorbidities and frequent exposure to medications that affect these organs. Therefore measurement of liver and spleen dimensions is very important in identification and follow-up of an abnormality in these organs. The physical examination including palpation and percussion is unreliable to assess for splenic and liver enlargement [1, 2]. Ultrasonography is the preferred radiologic method for assessment of any splenic and liver pathology because it provides a quick evaluation without ionizing radiation, is inexpensive and can be performed bed-side.

There are limited data on normative standards of splenic and liver dimensions in preterm newborns, and the number of cases in the literature is insufficient to obtain normal ranges. Therefore, we documented the ranges of liver and spleen dimensions in a large series of preterm newborns to establish a reference standard for use in daily practice.

Materials and methods

The ethics committee of the Ministry of Health Tepecik Teaching and Research Hospital approved this investigation. Written informed consent was obtained from all parents before enrollment in the study.

Patients

Sonography was performed prospectively on 498 preterm newborns (226 girls and 272 boys) who were admitted to the Neonatology Clinic of the Ministry of Health Tepecik Teaching and Research Hospital (a level III neonatal intensive care unit in Izmir, Turkey) between November 2011 September 2012, in the first week of their life. Infants with congenital anomalies, congenital or acquired infections, metabolic diseases and those who were small for gestational age were excluded from the study.

Gestational age was based on the mother’s last menstrual period. The spleen and liver dimensions were evaluated by one experienced radiologist (10 years of experience) to avoid interobserver differences and to standardize the precision between measurements. Each measurement was repeated at least three times, and the most repeated value was recorded. Children had no preparation or sedation prior to examination. Ultrasonography was performed with a Mindray M5 scanner (Mindray, Shenzhen, China) using a 5-MHz transducer. Transverse diameter of liver was obtained in the sagittal oblique plane, at the level of the hepatic hilum, and longitudinal diameter was obtained on the frontal axillary line in the sagittal plane with infants in the supine position. Longitudinal and transverse dimensions of the spleen were obtained on the posterior axillary line in the sagittal oblique plane with infants in the supine or slightly right lateral decubitus position.

Weight, height, gestational age and gender of the infants were recorded. Measurements were compared with gender, gestational age, weight and height. Correlations between the organ dimensions and the other parameters were statistically analyzed.

Statistical analysis

Statistical analysis was performed using the SPSS Statistics version 15.0 (SPSS Inc., Chicago, IL). We calculated the median, minimum and maximum values and 5th and 95th percentiles of dimensions according to gestational age, weight and height. The Mann–Whitney U test was used for comparing group averages. The Spearman rho test was used for the correlation of two variables. A P value less than 0.05 was considered statistically significant.

Results

Four hundred ninety-eight preterm newborns were examined. The mean gestational age, weight and height of the preterm infants were 30.6 ± 3.3 weeks, 1,594.9 ± 628.2 g and 40.1 ± 4.8 cm, respectively. Two hundred twenty-six (45.4%) infants were girls and 272 (54.6%) were boys. Longitudinal and anteroposterior dimensions of liver and spleen were statistically significantly smaller in girls than boys (P < 0.05). Therefore all data were arranged and separated according to gender.

Mean, minimum and maximum and 5th and 95th percentile values and standard deviations of the longitudinal and anteroposterior dimensions of the liver and spleen are presented according to gestational age, weight and height in Tables 1, 2, 3, 4, 5 and 6. Mean longitudinal and anteroposterior dimensions of the liver and spleen versus gestational age are plotted in Figs. 1, 2, 3, 4, 5, 6, 7 and 8.
Table 1

Longitudinal dimensions of the liver and spleen according to height

Organ

Gender

Height (cm)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

32 and less

22

36.8

31.7

42.5

31.7

42.2

32.1–35

34

40.2

32.8

50.7

33.7

49.6

35.1–38

44

41.5

36.9

52.7

37.4

50.4

38.1–41

53

47.8

37.9

55.8

39.0

54.9

41.1–43

19

48.7

45.9

62.6

45.9

62.6

43.1–45

24

52.8

39.0

61.1

40.2

60.6

45.1 and more

30

54.7

46.1

66.1

46.7

64.8

Boy

32 and less

11

36.9

26.1

47.4

26.1

47.4

32.1–35

31

41.3

32.9

51.0

34.9

48.9

35.1–38

42

44.2

33.6

53.2

36.9

52.4

38.1–41

52

46.2

35.9

56.8

39.6

54.5

41.1–43

50

50.3

42.6

60.1

42.9

57.6

43.1–45

36

53.0

42.7

63.8

45.2

61.5

45.1 and more

50

55.8

44.6

74.3

46.1

66.5

Spleen (mm)

Girl

32 and less

22

19.5

14.8

25.6

14.8

25.5

32.1–35

34

23.8

13.7

29.8

16.7

29.2

35.1–38

44

25.5

18.5

36.1

19.5

35.6

38.1–41

53

29.4

19.1

41.8

20.0

39.1

41.1–43

19

32.0

27.4

41.7

27.4

41.7

43.1–45

24

35.7

29.3

42.9

29.3

42.5

45.1 and more

30

39.4

28.0

46.3

28.4

45.9

Boy

32 and less

11

22.4

17.4

31.0

17.4

31.0

32.1–35

31

24.2

18.5

29.7

18.9

29.5

35.1–38

42

25.9

19.4

36.7

19.8

36.2

38.1–41

52

29.8

10.5

41.2

23.1

36.5

41.1–43

50

33.2

22.5

60.0

23.3

42.9

43.1–45

36

38.0

27.4

44.7

29.0

43.8

45.1 and more

50

37.2

23.5

51.3

25.7

48.5

Table 2

Anteroposterior dimensions of the liver and spleen according to height

Organ

Gender

Height (cm)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

32 and less

22

27.6

20.7

34.1

21.1

33.8

32.1–35

34

32.1

25.9

39.3

26.2

38.9

35.1–38

44

32.9

26.2

40.8

27.7

39.9

38.1–41

53

37.2

28.0

50.7

30.2

49.0

41.1–43

19

40.5

30.5

54.1

30.5

54.1

43.1–45

24

42.8

34.5

55.7

34.6

55.6

45.1 and more

30

44.6

35.6

58.9

36.6

58.6

Boy

32 and less

11

29.2

23.2

31.7

23.2

31.7

32.1–35

31

32.4

26.4

45.0

26.9

42.9

35.1–38

42

33.9

25.9

45.4

28.1

44.5

38.1–41

52

37.5

27.5

47.8

29.0

45.5

41.1–43

50

40.5

31.0

53.5

32.0

48.7

43.1–45

36

43.7

32.6

53.3

34.5

51.5

45.1 and more

50

44.5

35.4

58.4

36.7

56.3

Spleen (mm)

Girl

32 and less

22

9.0

4.8

15.1

4.9

14.8

32.1–35

34

10.8

7.6

14.5

8.1

14.4

35.1–38

44

11.5

8.3

16.7

9.0

14.1

38.1–41

53

13.1

7.4

17.2

8.4

16.3

41.1–43

19

12.5

9.5

19.2

9.5

19.2

43.1–45

24

15.6

11.4

21.6

11.7

20.8

45.1 and more

30

17.3

12.4

22.9

12.7

22.6

Boy

32 and less

11

8.9

7.7

14.3

7.7

14.3

32.1–35

31

11.1

8.0

14.9

8.2

14.6

35.1–38

42

12.0

5.1

17.7

8.4

16.2

38.1–41

52

12.9

7.2

19.1

9.4

17.8

41.1–43

50

13.8

8.8

23.7

9.7

19.3

43.1–45

36

15.7

12.2

22.3

12.3

20.0

45.1 and more

50

17.3

10.0

20.3

10.9

20.0

Table 3

Longitudinal dimensions of the liver and spleen according to weight

Organ

Gender

Weight (grams)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

750 and less

17

36.2

31.7

42.4

31.7

42.4

751–1,000

49

40.3

35.4

48.5

35.8

47.2

1,001–1,250

42

42.7

34.1

52.7

36.9

50.1

1,251–1,500

27

48.2

39.2

60.9

39.3

58.1

1,501–1,750

20

48.2

40.7

62.6

40.8

62.2

1,751–2,000

26

50.2

39.0

57.9

41.1

57.4

2,001–2,250

15

53.6

45.9

61.1

45.9

61.1

2,251–2,500

17

54.4

47.3

62.4

47.3

62.4

2,501 and more

13

56.5

52.0

66.1

52.0

66.1

Boy

750 and less

7

32.6

26.1

39.4

26.1

39.4

751–1,000

29

41.2

32.9

47.5

33.2

47.4

1,001–1,250

46

43.0

35.9

53.0

36.7

50.7

1,251–1,500

41

46.2

37.7

53.3

38.3

53.1

1,501–1,750

34

48.8

40.0

57.3

42.0

56.9

1,751–2,000

32

52.1

42.6

56.5

43.9

55.7

2,001–2,250

25

54.2

46.6

74.3

46.9

71.1

2,251–2,500

23

54.6

45.7

61.4

46.0

61.1

2,501 and more

35

56.8

45.7

70.0

47.2

65.0

Spleen (mm)

Girl

750 and less

17

19.2

14.8

25.6

14.8

25.6

751–1,000

49

23.7

13.7

36.1

18.1

29.4

1,001–1,250

42

26.2

19.0

36.1

20.0

35.1

1,251–1,500

27

28.3

24.6

41.7

24.7

39.3

1,501–1,750

20

29.6

22.7

41.8

22.8

41.6

1,751–2,000

26

32.8

22.0

40.1

24.1

40.0

2,001–2,250

15

35.0

29.3

41.7

29.3

41.7

2,251–2,500

17

38.8

28.8

45.6

28.8

45.6

2,501 and more

13

39.4

33.3

46.3

33.3

46.3

Boy

750 and less

7

22.1

18.5

31.0

18.5

31.0

751–1,000

29

23.6

17.4

29.0

17.8

28.4

1,001–1,250

46

26.1

19.4

34.2

22.2

32.2

1,251–1,500

41

29.7

10.5

36.3

21.0

34.6

1,501–1,750

34

31.7

23.5

42.0

25.9

39.9

1,751–2,000

32

34.0

22.5

43.7

22.8

42.4

2,001–2,250

25

35.5

27.4

44.2

27.9

43.3

2,251–2,500

23

35.7

26.3

44.7

26.4

44.4

2,501 and more

35

38.5

23.5

60.0

24.7

53.0

Table 4

Anteroposterior dimensions of liver and spleen according to weight

Organ

Gender

Weight (grams)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

750 and lower

17

27.7

20.7

38.8

20.7

38.8

751–1,000

49

31.8

25.4

39.3

25.8

38.3

1,001–1,250

42

33.0

27.7

42.8

28.0

42.4

1,251–1,500

27

37.9

30.5

46.0

31.4

45.9

1,501–1,750

20

36.6

28.0

48.4

28.0

48.3

1,751–2,000

26

42.5

30.5

54.1

30.8

52.9

2,001–2,250

15

43.6

35.6

49.0

35.6

49.0

2,251–2,500

17

44.1

36.3

58.9

36.3

58.9

2,501 and upper

13

46.3

36.5

58.4

36.5

58.4

Boy

750 and lower

7

27.5

23.2

31.7

23.2

31.7

751–1,000

29

30.5

25.9

39.5

26.1

38.8

1,001–1,250

46

33.8

27.3

45.0

27.6

44.0

1,251–1,500

41

37.9

28.8

45.3

29.3

45.0

1,501–1,750

34

38.8

32.1

48.8

32.4

48.7

1,751–2,000

32

41.4

31.9

46.9

34.1

46.9

2,001–2,250

25

44.4

37.2

54.1

37.4

53.4

2,251–2,500

23

43.5

35.4

56.8

35.5

56.1

2,501 and upper

35

46.1

34.9

58.4

35.4

56.4

Spleen (mm)

Girl

750 and lower

17

8.6

4.8

15.1

4.8

15.1

751–1,000

49

10.6

8.3

14.5

8.3

14.3

1,001–1,250

42

12.0

7.4

16.7

8.9

15.4

1,251–1,500

27

12.3

9.0

15.4

9.5

15.3

1,501–1,750

20

13.3

10.3

19.2

10.3

19.1

1,751–2,000

26

14.3

8.3

21.6

8.7

20.6

2,001–2,250

15

16.1

9.5

22.9

9.5

22.9

2,251–2,500

17

16.7

13.2

22.5

13.2

22.5

2,501 and upper

13

17.6

13.5

20.9

13.5

20.9

Boy

750 and lower

7

10.6

7.7

14.3

7.7

14.3

751–1,000

29

9.7

7.9

14.9

7.9

13.8

1,001–1,250

46

12.4

5.1

17.7

9.2

16.1

1,251–1,500

41

12.4

7.2

17.2

8.5

16.6

1,501–1,750

34

14.0

9.8

19.7

11.0

19.1

1,751–2,000

32

13.9

9.6

19.1

10.3

19.1

2,001–2,250

25

15.9

10.0

20.3

10.2

20.2

2,251–2,500

23

16.7

11.4

22.3

11.8

21.7

2,501 and upper

35

17.3

11.8

23.7

12.2

20.8

Table 5

Longitudinal dimensions of the liver and spleen according to gestational age based on the last menstrual period

Organ

Gender

GA (weeks)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

24 and less

12

36.6

31.7

40.5

31.7

40.5

25–26

27

38.8

32.4

49.3

32.5

48.9

27–28

39

41.0

32.8

54.1

35.4

52.7

29–30

43

44.3

37.6

55.1

38.9

53.2

31–32

43

48.1

37.9

62.6

42.4

60.4

33–34

29

51.2

39.0

61.1

39.8

60.2

35–36

33

54.3

45.9

66.1

46.6

64.4

Boy

24 and less

2

33.6

32.3

34.9

32.3

34.9

25–26

15

41.2

32.4

46.5

32.4

46.5

27–28

46

42.2

26.1

53.2

36.5

49.5

29–30

59

45.5

33.6

56.8

36.6

54.3

31–32

54

50.4

40.0

74.3

42.0

60.0

33–34

41

51.8

42.6

61.4

43.3

60.0

35–36

55

55.3

45.7

70.0

47.2

63.5

Spleen (mm)

Girl

24 and less

12

19.1

14.8

25.6

14.8

25.6

25–26

27

22.2

13.7

29.8

14.3

28.8

27–28

39

24.1

18.5

29.4

19.1

28.5

29–30

43

27.3

19.1

36.2

20.3

36.1

31–32

43

29.6

19.0

41.8

20.9

41.2

33–34

29

34.2

22.2

42.2

24.6

41.9

35–36

33

39.4

28.1

46.3

30.4

45.8

Boy

24 and less

2

20.4

18.5

22.4

18.5

22.4

25–26

15

23.9

18.3

29.0

18.3

29.0

27–28

46

25.4

17.4

34.8

18.7

34.5

29–30

59

28.2

10.5

43.7

22.0

37.1

31–32

54

32.3

22.5

44.2

23.8

42.4

33–34

41

36.3

23.5

60.0

25.9

42.6

35–36

55

37.2

23.5

51.3

26.0

47.8

Table 6

Anteroposterior dimensions of the liver and spleen according to gestational age based on the last menstrual period

Organ

Gender

GA (weeks)

No.

Median

Minimum

Maximum

Percentile

5th

95th

Liver (mm)

Girl

24 and less

12

27.4

20.7

36.9

20.7

36.9

25–26

27

32.1

24.9

39.3

25.3

39.1

27–28

39

31.4

24.6

40.5

25.4

39.1

29–30

43

35.7

27.1

50.7

28.2

43.5

31–32

43

40.0

28.0

54.1

29.2

50.0

33–34

29

41.4

31.7

55.4

32.8

52.6

35–36

33

43.4

34.5

58.9

35.7

58.5

Boy

24 and less

2

28.0

24.3

31.7

24.3

31.7

25–26

15

29.8

25.9

41.3

25.9

41.3

27–28

46

32.7

23.2

45.0

27.3

43.9

29–30

59

37.3

27.5

47.8

28.0

45.1

31–32

54

40.1

28.9

53.5

31.6

48.7

33–34

41

43.0

34.9

53.3

35.7

51.1

35–36

55

44.5

35.4

58.4

37.0

56.0

Spleen (mm)

Girl

24 and less

12

8.3

6.1

15.1

6.1

15.1

25–26

27

9.9

4.8

14.5

5.9

14.3

27–28

39

11.2

8.3

16.7

8.5

15.4

29–30

43

11.9

7.4

15.6

8.3

14.4

31–32

43

13.1

8.8

19.2

9.2

17.1

33–34

29

15.1

9.5

22.9

9.9

20.8

35–36

33

17.3

9.5

22.5

10.6

21.8

Boy

24 and less

2

8.3

7.7

8.9

7.7

8.9

25–26

15

9.7

8.0

14.3

8.0

14.3

27–28

46

11.7

7.9

17.7

8.4

16.9

29–30

59

12.5

5.1

18.3

8.5

16.6

31–32

54

14.2

9.6

20.0

10.8

19.7

33–34

41

15.6

9.8

23.7

10.7

19.9

35–36

55

16.9

10.0

22.3

10.7

20.1

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig1_HTML.gif
Fig. 1

Anteroposterior diameter of the spleen in boys. Sonographic anteroposterior dimension of the spleen (mm) by gestational age based on the last menstrual period (weeks) in boys from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig2_HTML.gif
Fig. 2

Anteroposterior diameter of the spleen in girls. Sonographic anteroposterior dimension of the spleen (mm) by gestational age based on the last menstrual period (weeks) in girls from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig3_HTML.gif
Fig. 3

Longitudinal diameter of the spleen in boys. Sonographic longitudinal dimension of the spleen (mm) by gestational age based on the last menstrual period (weeks) in boys from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig4_HTML.gif
Fig. 4

Longitudinal diameter of the spleen in girls. Sonographic longitudinal dimension of the spleen (mm) by gestational age based on the last menstrual period (weeks) in girls from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig5_HTML.gif
Fig. 5

Anteroposterior diameter of the liver in boys. Sonographic anteroposterior dimension of the liver (mm) by gestational age based on the last menstrual period (weeks) in boys from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig6_HTML.gif
Fig. 6

Anteroposterior diameter of the liver in girls. Sonographic anteroposterior dimension of the liver (mm) by gestational age based on the last menstrual period (weeks) in girls from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig7_HTML.gif
Fig. 7

Longitudinal diameter of the liver in boys. Sonographic longitudinal dimension of the liver (mm) by gestational age based on the last menstrual period (weeks) in boys from a cross-sectional dataset

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-013-2729-7/MediaObjects/247_2013_2729_Fig8_HTML.gif
Fig. 8

Longitudinal diameter of the liver in girls. Sonographic longitudinal dimension of the liver (mm) by gestational age based on the last menstrual period (weeks) in girls from a cross-sectional dataset

Longitudinal and anteroposterior dimensions of the spleen and liver showed high correlation with the gestational age, weight and height in girls and in boys. Weight was the parameter best correlated with all dimensions in both genders (Tables 7 and 8).
Table 7

Correlations between liver dimensions and gestational age, height and weight

Gender

Liver dimension

Gestational age

Height

Weight

Girl

Longitudinal

0.773

0.803

0.842

Anteroposterior

0.712

0.740

0.752

Boy

Longitudinal

0.762

0.797

0.824

Anteroposterior

0.682

0.686

0.734

Correlation is significant at the 0.01 level (2-tailed)

Table 8

Correlations between splenic dimensions and gestational age, height and weight

Gender

Splenic dimension

Gestational age

Height

Weight

Girl

Longitudinal

0.798

0.803

0.829

Anteroposterior

0.676

0.692

0.752

Boy

Longitudinal

0.682

0.726

0.759

Anteroposterior

0.613

0.648

0.679

Correlation is significant at the 0.01 level (2-tailed)

Discussion

Preterm newborns have immature functioning of the liver and spleen and usually have comorbidities and frequent exposure to medications that affect the functioning of these organs [3]. Therefore the evaluation of liver and spleen size and morphology is important in this age group. Sonography is a simple, quick, non-invasive technique to visualize and measure the dimensions of the spleen and liver without the risk of ionizing radiation. But the normal range of organ dimensions must be known before an abnormality can be diagnosed.

Studies about splenic and liver dimensions in pediatric age groups, especially newborns, are rare and only a few have investigated these organ sizes in preterm newborns. We found only two studies that sonographically evaluated liver and spleen dimensions in healthy preterm newborns. One was published in 2002 by Soyupak et al. [4] and included splenic and liver dimensions of 99 preterm newborns; the other was published in 2007 by Megremis et al. [5] and included spleen dimensions of 96 premature infants. Our study includes the largest series of splenic and liver dimensions in preterm newborns.

Other studies found no statistically significant difference in spleen and liver dimensions based on gender in newborns, infants and children [1, 2, 4, 5]. However we found that the spleen and liver were significantly smaller in girls than in boys. Our study is unique in that it includes reference ranges of liver and spleen dimensions according to gender.

We compared splenic and liver dimensions with height, weight and gestational age and developed tables based on our findings. We found a strong correlation between these parameters and organ dimensions. Dittrich et al. [6] studied liver and spleen dimensions in 194 children and found good correlation between height and organ sizes. Similarly, Konus et al. [1] reported that height showed the best correlation with spleen and liver lengths in newborns. In contrast to these studies, Rosenberg et al. [2] studied splenic dimensions in 230 children and found that weight correlated best with the dimensions against age and height. Similarly in the study by Soyupak et al. [4], which included 261 healthy newborns, the best correlation was found between the splenic and liver dimensions and weight. Likewise in our study weight was the parameter best correlated with spleen and liver dimensions. We developed charts on spleen and liver dimensions with regard to gestational age, a parameter that is easily accessible in routine practice.

One drawback of our study is the use of the last menstrual period to estimate gestational age. Premature birth is associated with early gestational bleeding and that could confound the results. The other drawback is the use of one measurement point per child. Because of this lack of measurements over time the nomograms are not useful in terms of growth.

Conclusion

The tables and diagrams based on our data include the reference ranges of spleen and liver dimensions according to gestational age, weight and height. These data should be very useful for assessment of these organs sonographically in preterm newborns.

Conflict of interest

None.

Copyright information

© Springer-Verlag Berlin Heidelberg 2013