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Study on Diagnostic Methods for Spleen in Complex Heart Disease.

Journal of the Korean Pediatric Society 1988;31(7):833-840.
Published online July 31, 1988.
Study on Diagnostic Methods for Spleen in Complex Heart Disease.
Jung Yun Choi1, Yong Soo Yun1, Chung Il Noh1, Chang Yee Hong1, Kyung Mo Yeon2, In One Kim2
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Pediatric Radiology, College of Medicine, Seoul National University, Seoul, Korea
선천성 심기형 환아에서 비장확인 방법에 관한 연구 -무비증과 다비증을 중심으로-
최정연1, 윤용수1, 노정일1, 홍창의1, 연경모2, 김인원2
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 방사선과학교실
Received: 9 June 1988   • Accepted: 9 June 1988
Thirty one cases of congenital heart disease with suspicious splenic anomaly were prospectively studied at Seoul National University Children’s Hopsital from October, 1986 to February, 1988 in order to determine the sensitivity and the specificity of various non-invasive diagnostic methods for splenic status. In most cases, splenic status was confirmed by abdominal aortography. Each case had chest X-ray, abdominal X-ray, bronchus tomography, electrocardiogram, echocardiography, abdomi- nal ultrasound examination, peripheral blood smear for Howell-Jolly body and radioisotope spleen selective scan using technetium. On the basis of aortographic findings and, other findings if necessary, splenic status was classified into 1) asplenia, 2) polysplenia, 3) normal spleen, 4) mirror image spleen. Radioisotope scan and abdominal ultasound examination were very sensitive and specific to detect asplenia, normal and mirror image spleen. But neither of them were sensitive to find polysplenia. In contrast, left isomerism on bronchus tomography and inferior vena cava interruption were good indicator of polysplenia. Relative position of inferior vena cava and aorta at 12th thoracic vertebrae level was neither sensitive or specific to asplenia. Three fourth of asplenia showed Howell-Jolly body. P wave axis on electrocardiogram was not helpful to define splenic status. Simple chest and abdominal X-ray were not helpful either. There was no single non-invasive diagnostic method applicable to all splenic status, but two or more methods will make accurate diagnosis of splenic status.
Key Words: Asplenia, Polysplenia, Cardiosplenic syndrome, Right isomerism, Left isomerism.

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