Laparoscopic splenectomy: multi-detector row CT for preoperative evaluation.
OBJECTIVE
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.


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 alpha). 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, alpha 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.


CONCLUSIONS
Multi-detector row CT volumetric and anatomic evaluation provided accurate and reproducible information.
Department of Radiology, University of Rome La Sapienza, Viale Regina Elena, 324, 00100 Rome, Italy. alessandro.napoli@uniroma1.it
Alessandro
A
Napoli
Carlo
C
Catalano
Gianfranco
G
Silecchia
Paolo
P
Fabiano
Francesco
F
Fraioli
Federica
F
Pediconi
Fiammetta
F
Venditti
Nicola
N
Basso
Roberto
R
Passariello
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D010535:Laparoscopy; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000000981:diagnostic imaging* / Q000601:surgery*; D012680:Sensitivity and Specificity; D013103:Spherocytosis, Hereditary / Q000000981:diagnostic imaging* / Q000601:surgery*; D013154:Spleen / Q000002:abnormalities / Q000098:blood supply* / Q000000981:diagnostic imaging*; D013156:Splenectomy; D036542:Tomography, Spiral Computed; D017086:beta-Thalassemia / Q000000981:diagnostic imaging* / Q000601:surgery*