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Laparoscopic Splenectomy: Multi–Detector Row CT for Preoperative Evaluation¹

¹ From the Departments of Radiology (A.N., C.C., F.F., F.P., F.V., R.P.) and Surgery "P. Stefanini" (G.S., P.F., N.B.), University of Rome "La Sapienza," Viale Regina Elena, 324, 00100 Rome, Italy. From the 2003 RSNA scientific assembly. Received March 22, 2003; revision requested June 13; final revision received January 14, 2004; accepted January 29. Address correspondence to A.N. (e-mail: alessandro.napoli@uniroma1.it).

PURPOSE: To prospectively evaluate multi–detector row spiral computed tomography (CT) for determination of splenic volume, splenic vascular anatomy, and presence of accessory spleens and parenchymal lesions in patients who were undergoing laparoscopic splenectomy.

MATERIALS AND METHODS: Twenty-two patients who were candidates for laparoscopic splenectomy underwent multiphasic multi–detector row CT. Two observers evaluated splenic volume with two hand-tracing editing modalities. Variability between the two observers was calculated with a reliability coefficient (Cronbach ). A linear regression equation for each modality was generated to identify the correlation between the two observers. Multi–detector row CT angiography was evaluated for assessment of splenic vascular anatomy. Presence and number of both accessory spleens and parenchymal lesions were recorded.

RESULTS: Mean splenic volume was 1,050 and 1,046 mL, respectively, for observers A and B by using each-section editing (technique 1) and 1,067 and 1,068 mL for observers A and B by using distanced editing (technique 2). For each editing modality, reliability coefficient was higher than 0.99. Both techniques 1 and 2 were very highly predictive of specimen weight and had R² values of greater than 0.99 (P < .001). CT angiograms correctly showed polar arteries in all cases and the presence of the arteria pancreatica magna in one case. Multi–detector row CT demonstrated the presence, number, and size of all accessory spleens and of focal parenchymal lesions.

CONCLUSION: Multi–detector row CT volumetric and anatomic evaluation provided accurate and reproducible information.

© RSNA, 2004

Index terms: Computed tomography (CT), maximum intensity projection, 775.12119 • Computed tomography (CT), multi–detector row, 775.12115 • Computed tomography (CT), volume rendering, 775.12119 • Spleen, CT, 775.12115, 775.12116, 775.12117, 775.12118, 775.12119 • Spleen, size, 775.92

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