Value of the measurement of portal flow velocity in the differential diagnosis of asymptomatic splenomegaly.
OBJECTIVE
This prospective study was carried on 20 patients (10 with liver cirrhosis and 10 with myelo-lymphoproliferative disorders), consecutively admitted to our ward for splenomegaly and thrombocytopenia, with the aim of evaluating the ability of Duplex-Doppler ultrasonography (DDUS) to discriminate between congestive splenomegaly and enlarged spleen caused by haematological disorders.


RESULTS
Comparing the clinical/laboratory and DDUS findings for the two groups, it emerged that maximum-portal flow velocity (PFV) values revealed the most statistically significant differences: 17.31 SD 2.48 vs. 28.27 SD 3.53 (cm/s, P < 0.001). Discriminant analysis showed that max-PFV is the variable which by itself maximizes the separation between the two groups (F = 71.56; P < 0.0001). The patients with congestive splenomegaly exhibited lower max-PFV than the controls (17.31 SD 2.48 vs. 26.29 SD 2.38 cm/s, P < 0.001), unlike those with haematological diseases, whose max-PFV values were greater, albeit not significantly so (28.27 SD 3.53 vs. 26.29 SD 2.38 cm/s, P = 0.161).


CONCLUSIONS
DDUS assessment of portal haemodynamics thus proved useful in the differential diagnosis of splenomegaly in asymptomatic patients since it distinguishes rapidly and non-invasively between congestive and haemotological splenomegaly. A lower-than-normal max-PFV value indicates congestive splenomegaly; a highish value, on the other hand, suggests a splenomegaly of haematological origin.
Tincani
E
E
Department of Internal Medicine, University of Modena, Italy.
Cioni
G
G
D'Alimonte
P
P
Cristani
A
A
Turrini
F
F
Sardini
C
C
Romagnoli
R
R
Ventura
E
E
D000328:Adult; D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013163:Splenomegaly / Q000000981:diagnostic imaging* / Q000209:etiology*; D018616:Ultrasonography, Doppler, Duplex