Liver measurements on computed tomography: a guide for day-to-day practice in the Saudi population

BACKGROUND:
Liver size can indicate the presence of liver diseases such as cirrhosis, hepatitis, and malignancy. Accurate assessment of liver span is essential for the early identification of liver pathologies.


OBJECTIVES:
The objective of this study is to establish a reference value for the average liver size of the Saudi population using abdominal computed tomography (CT) scans. A secondary objective of the study is to explore the correlations of demographic factors and comorbidities with liver size.


DESIGN:
A retrospective cross-sectional study


SETTING:
Tertiary healthcare center in Riyadh, Saudi Arabia


PATIENTS AND METHODS:
A retrospective cross-sectional analysis of liver span, liver width, and spleen span was performed. The maximum oblique craniocaudal (MaxCC) length and transverse width of the liver and maximum length of the spleen were obtained in coronal view. The demographic characteristics and comorbidities of patients were collected.


MAIN OUTCOME MEASURES:
Liver span, width, and spleen span of the study population. In addition to demographic characteristics and comorbidities that were correlates of larger liver size.


SAMPLE SIZE:
2500 adult patients who underwent CT scans for conditions unrelated to liver disease.


RESULTS:
The mean (SD) liver span of the study population was 17.6 cm (2.4), while mean liver width was 18.9 cm (2.8). Multivariate analysis showed that a larger liver span was significantly correlated with increased age, height, a diagnosis of diabetes, as well as fatty liver and a larger BMI score.


CONCLUSIONS:
Measurement of the liver span using the MaxCC length and liver width is a simple method for routine clinical screening. The values established are useful in screening for liver disease that causes hepatomegaly and should therefore be used more frequently in a clinical setting in CT imaging.


LIMITATIONS:
Retrospective single-center design and reliance on CT-based diagnosis of fatty liver, which may not detect subclinical steatohepatitis.