title: An anatomic and morphometric analysis of splenic variability using 3D reconstruction and spatial orientation from computed tomography.
abstract: BACKGROUND
  In terms of frequency, the spleen is the first organ affected in abdominal trauma, resulting even today in a high rate of mortality (10%). Nevertheless, very few studies have investigated splenic quantitative morphometry as to shape and spatial orientation. Therefore, we analysed healthy spleen variability in order to integrate it in its environment and to correlate its morphometric parameters to anthropometric characteristics.
  
  
  METHODS
  Ninety abdominopelvic CT-scans performed on patients over 16 years with no splenic pathology were retrospectively selected among a Mediterranean population. Three age groups ([16-30], [30-60] and [over 60 years]), equally distributed among genders, were created. Parameters, such as volume, characteristic checkpoints, orientation, and morphology, were measured on the spleen, the 11th thoracic vertebra and the 10th ribs in three-dimensional reconstructions. Anthropometric parameters were characterised by waist circumference, costo-xiphoid angle, abdominal height and chest depth.
  
  
  RESULTS
  Observed variations in splenic morphology were divided into three groups: cupped (66.7%), coiled (17.8%), and flat (15.5%). Splenic morphometry tends to be abdominal-shaped (54.5%) or dorsal-shaped (45.5%). The mean of the angle between the main axis of the spleen and the CT-scan horizontal axis was 40±14°. Correlations were highlighted between volume and gender (p<0.05), splenic morphology and liver morphometry (p<0.05) as well as between orientation of hilar surface and splenic morphometry (p<0.01). Moreover, the spleen is more horizontal in women (p<0.05), in the elderly (p<0.05) and in the obese (p<0.01).
  
  
  CONCLUSIONS
  This study defines three groups based on shape and highlights correlations between parameters describing healthy splenic variability and its anthropometric characteristics, which are of great importance for numerical modelling in splenic studies.
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France. Electronic address: annesophiestuder@yahoo.fr.
authors.forename: A-S
authors.initials: AS
authors.lastname: Studer
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France.
authors.forename: C J F
authors.initials: CJ
authors.lastname: Kahn
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France.
authors.forename: T
authors.initials: T
authors.lastname: Bege
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Thollon
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; Department of Public Health and Biostatistics, Faculty of Medicine, Aix Marseille University, Assistance Publique - Hôpitaux de Marseille, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Loundou
authors.affiliation: AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France.
authors.forename: K
authors.initials: K
authors.lastname: Chaumoître
authors.affiliation: AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Coze
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Berdah
authors.affiliation: Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Brunet
mesh_terms: D000005:Abdomen / Q000033:anatomy & histology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D000886:Anthropometry; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000473:pathology; D012189:Retrospective Studies; D012727:Sex Characteristics; D013154:Spleen / Q000033:anatomy & histology* / Q000254:growth & development / Q000473:pathology; D013909:Thorax / Q000033:anatomy & histology; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference; D055815:Young Adult
keywords: Anthropometry; Spleen; Splenic anatomy; Splenic morphology; Variability