Spleen-left kidney ratio and liver-right kidney ratio: novel measures of normal liver, spleen, and kidney dimensions in Southwestern Nigerian children

J Ultrasound. 2021 Sep;24(3):297-302. doi: 10.1007/s40477-020-00521-3. Epub 2020 Sep 11.

Abstract

Purpose: Figures can sometimes be difficult to handle when considering whether the ultrasound dimensions of the liver, spleen, and kidneys of children are within normal limits in a typical clinical setting. Therefore, it is imperative to think of a simple measure that can be easily adopted when the question of whether these organs are enlarged or reduced in size is to be answered by a sonologist. We hypothesize that the liver-right kidney ratio and spleen-left kidney ratio are constant, regardless of age and sex among children, provided that the reference organ is not diseased.

Methods: This observational, cross-sectional study was carried out in public primary schools in the Ogbomoso metropolis. A total of 1000 apparently healthy children aged 5-13 were subjected to abdominal sonography from July 2016 to December 2016. The length of the liver, spleen, and both kidneys as well as the anthropometric parameters of each subject were obtained and correlated. Data were analyzed using SPSS version 20.

Results: The SPL:LKL (spleen to left kidney length) ratio varies with age, and this is statistically significant in female subjects (p = 0.042), but not in males (p = 0.360). The RLL:RKL (right lobe of the liver to right kidney length) ratio of 1.19 ± 0.18 does not significantly vary with age or sex (p = 0.337).

Conclusion: The SPL:LKL ratio of 1.11 ± 0.18 can be only used as a measure of normality of organ dimensions in males. On the contrary, the RLL:RKL of 1.19 ± 0.18 can be used in all children, regardless of sex, provided that the reference organ is normal.

Keywords: Children; Kidney; Liver; Ratio; Spleen; Ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kidney* / anatomy & histology
  • Kidney* / diagnostic imaging
  • Liver / anatomy & histology
  • Liver / diagnostic imaging
  • Male
  • Nigeria
  • Organ Size
  • Reference Values
  • Spleen* / anatomy & histology
  • Spleen* / diagnostic imaging
  • Ultrasonography