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Acta Radiologica
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Ultrasound assessment of normal ! The Foundation Acta Radiologica
2020
liver, spleen, and kidney dimensions Article reuse guidelines:
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in southwest Nigerian children: DOI: 10.1177/0284185120948488
journals.sagepub.com/home/acr

a bedside formula for sonologists

Folasade T Akinlade1 , Christianah M Asaleye2,

Oluwagbemiga O Ayoola2 and Ademola A Aremu1

Abstract
Background: Knowledge of the normal sizes of the liver, spleen, and kidneys is important to radiologists when
assessing for pathology using ultrasound scan. The need for a local determination of a easy-to-use formula for estimating
the expected normal sonographic dimensions of these organs in children in order to serve as baseline when assessing
them for pathology cannot be over emphasized.
Purpose: To determine ultrasonographic sizes of the liver, spleen, and kidneys among primary school children in
southwestern Nigeria and correlate these with anthropometric measures to provide local reference data and an
easy-to-use formula for assessing these organs for pathology in clinical practice.
Material and Methods: This is an observational, cross-sectional study using 1000 public primary school children in
Ogbomoso. Sonographic dimensions of their liver, spleen, and both kidneys with anthropometric parameters were
obtained and correlated. Data were analyzed using SPSS version 20.
Results: The liver span was higher in boys than in girls (P ¼ 0.048) while the left lobe of the liver was higher in girls than in
boys (P ¼ 0.003). The spleen length was higher in boys than in girls (P ¼ 0.011). There was no gender difference in kidney
dimensions (P > 0.05). All anthropometric measures correlated significantly (P < 0.001) with organ dimensions. Body
surface area is the strongest predictor of the liver and kidney sizes (P < 0.001) and height for spleen size (P < 0.001).
Conclusion: Nomograms for the liver, spleen, and kidneys and regression equations for estimating the dimensions of
these organs were formulated based on the best multivariate correlates.

Keywords
Kidney, liver, spleen, ultrasound, children, formulae, dimension
Date received: 23 April 2020; accepted: 8 July 2020

Introduction
Knowledge of the normal dimensions of the
liver, spleen, and kidneys is not only important to radi-
ologists but also to clinicians when assessing these
organs for pathology. This is especially important
in the pediatric age group due to the organ size increas-
ing with age. The dimensions of organs have been
shown to change with pathologic states: while
some diseases cause an increase in size, others cause a
reduction in size and the direction of change in organ
size can be used to predict the prognosis of some dis-
eases (1–3).
Many studies have shown that the size and/or meas-
urements of the liver, spleen and kidneys are influenced
by many factors such as age, ethnicity, race, gender,
1
Department of Radiology, LAUTECH Teaching hospital, Ogbomoso,
Oyo State, Nigeria
2
Department of Radiology, Obafemi Awolowo University Teaching
Hospitals Complex, Ile-Ife, Osun State, Nigeria
Corresponding author:
Folasade T Akinlade, Radiology Department, LAUTECH Teaching
Hospital, Ogbomoso, Oyo State, Nigeria.
Email: sadeakinlade@gmail.com
2 Acta Radiologica 0(0)
weight, and height (4,5). It has been estimated that
between birth and adulthood, there is an increase in
liver mass of least tenfold (6,7). Hepatomegaly is a fre-
quent clinical finding in children and may be caused by
intrinsic liver diseases or by systemic alterations. In
case of clinical suspicion, ultrasonography (US) is gen-
erally the first method of choice when investigating
pediatric patients (8). In a similar vein, altered spleen
size can be due to infective, infestation, infiltrative,
immunologic, and malignant conditions; examples of
these diseases are malaria, tuberculosis, typhoid fever,
and other water-borne parasitic infections that are a
major public health concern in Nigeria (2,4,9). In
2003, it was estimated that half of the Nigerian popu-
lation has at least one episode of malaria annually and
the majority of outpatient visits can be attributed to
malaria (3). Evaluation of kidney measurements such
as length, width, and thickness is an important param-
eter in the diagnosis as well as management of many
kidney disorders as it is known that there is a close
relationship between the size of the kidney and its func-
tion (10,11).
In common practice, measurements of the size of
these organs at any age are compared with the dimen-
sions that are predicted by standard nomograms. The
current normal graphs that are widely used locally are
derived largely from studies based on Caucasian pop-
ulations of relatively small sample sizes (5,8).
Therefore, the aims of the present study were to
bridge the gap in knowledge by formulating an age–
specific, anthropometric-correlated nomogram of liver,
spleen, and kidney measurements and to develop a
regression equation that can be easily used by both
the sonologist and the physician, by the bedside,
when assessing these organs for pathology and moni-
toring response to therapy among a Nigerian pediatric
population in the southwest.
Material and Methods
This is a descriptive, cross-sectional study of liver,
spleen, and kidney parameters among Nigerian chil-
dren in primary schools. It was carried out at public
primary schools in Ogbomoso metropolis from March
2016 to October 2016.
A multi-staged sampling method was used. A total
of 1000 pupils (500 boys, 500 girls; age range ¼ 5–13
years) were recruited into the study. Based on propor-
tionate sampling, 500 children were recruited from each
of the two local governments in Ogbomoso. Five pri-
mary schools were chosen in each local government by
simple random sampling. Pupils were selected by sys-
tematic random sampling among volunteers from each
class (primary 1–6) based on the school’s population
and number of children in each school.
Exclusion criteria
The clinical exclusion criteria included: refusal to par-
ticipate; jaundice; fever (T > 37.5  C); maculopapular
rash; significant lymphadenopathy; short stature
(<2 SD for age); limb deformity; malnutrition; obesity;
pallor; macrocephaly (head circumference >2SD for
age); microcephaly (head circumference <2SD for
age); chest wall deformity; and known liver, spleen,
kidney, and systemic diseases.
The imaging exclusion criteria included: liver,
spleen, and kidney parenchymal mass lesions; abnor-
mal parenchymal echotexture and echogenicity; liver,
spleen, and kidney cysts; accessory spleens; and
hydronephrosis.
Data collection instrument
A semi-structured questionnaire was used. This was
pretested among 10 children attending a public primary
school outside of the selected schools in Ogbomoso and
it was administered by the interviewer. Data collection
also used tape measures, weighing scales, examination
couches, and acoustic gel.
Demographic data were collected from each partic-
ipant at the time of their pre-participation physical
examination. This information included: age; sex;
height and body weight; body surface area (BSA);
and body mass index (BMI), computed from measured
height and weight. BMI was calculated as weight (kg)/
height (m2) while BSA was calculated as 冑weight 
height/3600. Anthropometric measurements were
obtained on the participants wearing school uniform
without shoes. Weight was measured on a calibrated
portable Salter scale to the nearest 0.1 kg. Height was
measured with a metal tape measure to the nearest
0.5 cm with the participants standing upright with the
head in the Frankfurt position.
Scanning was done with the individual lying in the
supine position, while the area scanned was exposed.
The participant’s right upper limb was then raised
behind the head to help widen the intercostal spaces
and the space between the lower costal margin and
the iliac crest, thereby creating better access to the
liver (12). Scanning was done in both sagittal and
transverse views by two radiologists.
Using a 2.5–5 MHZ curvilinear transducer of a full
digital portable ultrasound diagnostic device (Sonoace
X1, Shangai Medison Medical instruments Co. Ltd,
China), the diagonal length of the liver (liver span)
was measured in the supine position while the length
of the spleen was measured in the right lateral decubi-
tus position. The length, width, and thickness of the
kidneys were measured in the prone position. The
dimensions of these organs were taken during deep
Akinlade et al.
inspiration. All measurements were obtained to the
nearest millimeter on static original ultrasound
images using electronic calipers at the time of scanning.
Two sequential measurements were obtained for each
organ dimension with the image frozen in inspiration,
and their mean was calculated; this was to minimize
intra-observer error and ensure greater accuracy and
reliability of the measurements (12,13).
According to the methods described earlier (6–9),
the diagonal axis of the liver from its most inferior
aspect on the right to the most lateral aspect on the
left was measured as the liver span (Fig. 1). The tech-
nique of the right lateral decubitus position in the cor-
onal plane was adopted for the spleen length
measurement. Longitudinal size measurement was per-
formed between the most superomedial and the most
inferolateral points of the spleen (Fig. 2). The maxi-
mum length of each kidney was measured between
the uppermost edge of the upper pole and the lowest
edge of the lower pole (bipolar diameter) of the kidney
and the anteroposterior (AP) diameter was measured
Figure 1. A B-mode longitudinal ultrasound image through the
right lobe of the liver at the mid-clavicular line showing the liver
and the right kidney. A to B ¼ liver span.
Figure 2. A B-mode coronal ultrasound image through the
spleen showing the spleen and the left kidney. A to B ¼ splenic
length.
3
between the most anterior and posterior capsule
while the participant lies in the prone position. The
probe was then rotated 90 and cross-sectional meas-
urements of the kidney width at the hilar level was
performed (Figs. 3 and 4). These measurements were
obtained with the patient lying prone. Kidney volumes
were calculated by using the standard formula for
ellipsoid structures (volume ¼ length  width  AP
diameter  0.52).
The data sheet was sorted out manually. Data from
the questionnaires and the liver, spleen, and kidney
ultrasonographic measurements were entered into sta-
tistical package for Social Scientists (SPSS) computer
software, version 20 (SPSS, Chicago, IL, USA).
Frequency distribution tables were used to present
results. The chi-square test was used to test association
between qualitative variables. The Student’s t-test was
used as a test of association between two continuous
variables while analysis of variance (ANOVA) was
Figure 3. A B-mode longitudinal ultrasound image through the
right kidney showing the kidney and part of the right lobe of the
liver. A to B ¼ kidney length, C to D ¼ anteroposterior dimen-
sion of the kidney.
Figure 4. A B-mode transverse ultrasound image through the
right kidney showing the kidney and part of the right lobe of the
liver. A to B ¼ kidney width.
4 Acta Radiologica 0(0)

used when there were > 2 continuous variables. Level
of significance was set at P < 0.05.
Ethical consideration
Ethical clearance was obtained from the local review
board of the hospital. Permission was taken from the
respective school board. Written informed consent was
sought from the parent of each child and any parent
who declined had his/her child excused from the study.
The parents were reassured that no harm would be
done to their children.
Results
Of the study population, 971 (97.1%) were of Yoruba
ethnicity, 19 (1.9%) were Hausa, 6 (0.6%) were Igbo,
and 4 (0.4%) were from other tribes.
The mean age of the girls was 9.37  2.3 years while
that of the boys was 9.36  2.3 years (P ¼ 0.978). The
average height of the participants was 128.6  12.8 cm
(range ¼ 99.0–173.0 cm) and the average weight was
26.8  7.2 kg (range ¼ 16.0–55.0 kg). The calculated
average BMI was 16.0  2.1 kg/m2 and the average
BSA was 0.97  0.18 m2 (range ¼ 0.52–1.60 kg/m2).
There was no statistically significant difference between
the age, height, weight, BMI, and BSA of both sexes
(P ¼ 0.978, 0.352, 0.720, 0.658, and 0.521, respectively);
thus, boys and girls were anthropometrically matched.
The liver span, spleen length, kidney length, and
volume by age, height, weight, BMI, and BSA are as
depicted in Tables 1 and 2.
Table 3 shows the relationship between anthropo-
metric parameters and liver span, spleen length,
kidney length, and volume on multivariate analysis.
BSA indicated significantly strong correlation of the
univariate analysis with liver span, kidney length, and
kidney volumes (P < 0.001), while age (P ¼ 0.016) and
height (P < 0.001) indicated significantly strong corre-
lations of the univariate analysis with splenic length.
Based on the evidence from the multivariate analy-
sis, regression equations were developed for the bedside
assessment of the liver span, spleen length, kidney
length, and kidney volumes in children as depicted in
Table 4.
Discussion
The evaluation of liver, spleen, and kidney measure-
ments is very important to the clinician as the result
can be used as baseline when assessing these organs for
pathology. Earlier studies carried out on these organs
in Nigerian children were mainly among those of Igbo
ethnicity (age range ¼ 5–17 years) (2,12). The present
study was conducted among children who were mainly
of Yoruba ethnicity (age range ¼ 5–13 years) (97.1%).
Similar findings by Ezeofor et al. (12) and Farheen
(14), that the liver dimensions were higher in boys, is
observed in the present study, but is in contrast with
other studies where no gender variation was found
(2,4,6,8,9,15,16). An earlier study on the ultrasound
dimensions of the liver among southeastern Nigerian
children by Eze et al. (15) also quoted a higher liver
dimension in boys. This contrast might be due to the

Table 1. Distribution of spleen and liver dimensions by age and sex.

Percentile Percentile
Age Spleen length Liver
Sex (years) Height (cm) Weight (kg) BMI (kg/m2) BSA (m2) (cm)(mm) 5th 95th span (cm) 5th 95th

Female 5 109.7  6.4 18.4  2.7 15.3  1.9 0.75  0.07 4.24  0.70 3.07 4.24  0.70 10.7  1.2 8.9 12.5
6 112.0  7.9 19.1  4.7 15.1  2.6 0.77  0.12 4.56  0.98 3.00 4.56  0.98 10.5  1.3 8.6 12.3
7 117.8  6.6 22.0  3.5 15.8  2.1 0.85  0.08 5.29  1.42 3.91 5.29  1.42 11.3  0.9 9.8 12.7
8 122.4  6.1 23.7  4.1 15.8  1.9 0.90  0.10 4.64  0.87 3.31 4.64  0.87 11.0  1.0 9.3 12.5
9 125.0  6.4 24.6  4.2 15.7  2.1 0.92  0.09 4.84  0.89 3.47 4.84  0.89 11.3  1.0 9.7 13.0
10 130.0  6.3 26.7  4.9 15.7  2.1 0.98  0.11 5.16  0.97 3.87 5.16  0.97 11.8  1.1 10.0 13.8
11 138.6  7.6 31.3  5.3 16.2  1.9 1.10  0.12 5.08  1.00 3.87 5.08  1.00 12.2  1.2 10.3 13.9
12 143.0  3.6 34.9  7.6 16.9  2.3 1.17  0.15 5.39  1.00 4.20 5.39  1.00 12.4  1.2 10.8 14.4
13 147.3  6.1 38.1  7.2 17.4  2.4 1.25  0.14 5.80  1.45 4.11 5.80  1.45 12.4  1.3 10.6 14.6
Male 5 110.7  5.4 19.1  2.2 15.6  1.4 0.77  0.06 4.78  1.10 3.31 4.78  1.10 11.2  1.2 9.6 14.0
6 113.8  7.3 19.1  3.9 14.7  2.3 0.77  0.10 4.55  0.80 3.24 4.55  0.80 11.0  1.1 9.3 13.1
7 119.3  6.1 22.6  3.6 15.9  2.1 0.86  0.08 4.78  1.01 3.47 4.78  1.01 11.1  1.0 9.7 12.8
8 123.5  7.6 24.8  4.1 16.3  1.9 0.92  0.10 5.14  1.01 3.78 5.14  1.01 11.5  1.4 10.1 13.4
9 125.9  6.5 24.8  4.0 15.6  1.9 0.93  0.09 4.99  1.11 3.50 4.99  1.11 11.7  0.9 10.3 13.1
10 130.5  7.7 27.3  4.7 16.0  1.8 0.99  0.11 5.07  0.90 3.72 5.07  0.90 11.9  1.1 10.1 13.9
11 135.0  5.9 29.5  3.8 16.2  1.3 1.05  0.09 5.19  1.14 3.58 5.19  1.14 11.9  1.0 10.5 13.7
12 139.5  6.6 32.1  4.6 16.5  1.7 1.11  0.10 5.17  1.23 3.62 5.17  1.23 12.4  1.0 10.5 13.9
13 145.9  9.7 35.6  5.6 16.7  1.7 1.20  0.12 5.32  0.90 4.12 5.32  0.90 12.5  1.1 10.8 14.4
Akinlade et al. 5

Table 2. Distribution of prone right kidney length and volume by age and sex.

Percentile Percentile
Age Right kidney Right kidney
Sex (years) Height (cm) Weight (kg) BMI (kg/m2) BSA (m2) length (cm) 5th 95th volume (cm3) 5th 95th

Female 5 109.7  6.4 18.4  2.7 15.3  1.9 0.75  0.07 7.52  0.58 6.39 8.22 54.0  8.4 40.4 71.4
6 112.0  7.9 19.1  4.7 15.1  2.6 0.77  0.12 7.63  0.59 6.76 8.83 51.4  11.2 32.9 75.8
7 117.8  6.6 22.0  3.5 15.8  2.1 0.85  0.08 7.90  0.58 7.00 9.15 56.8  10.7 41.3 73.1
8 122.4  6.1 23.7  4.1 15.8  1.9 0.90  0.10 7.98  0.66 6.59 9.16 58.7  9.5 37.4 72.2
9 125.0  6.4 24.6  4.2 15.7  2.1 0.92  0.09 7.88  0.73 6.84 9.21 59.8  13.0 42.2 82.1
10 130.0  6.3 26.7  4.9 15.7  2.1 0.98  0.11 8.18  0.61 7.22 9.14 65.1  11.8 48.0 87.1
11 138.6  7.6 31.3  5.3 16.2  1.9 1.10  0.12 8.55  0.68 7.63 9.74 70.9  15.2 49.0 93.5
12 143.0  3.6 34.9  7.6 16.9  2.3 1.17  0.15 8.93  0.93 7.61 10.33 80.4  17.8 56.1 106.4
13 147.3  6.1 38.1  7.2 17.4  2.4 1.25  0.14 8.99  0.70 7.62 9.98 84.5  16.2 58.5 109.1
Male 5 110.7  5.4 19.1  2.2 15.6  1.4 0.77  0.06 7.72  0.64 6.36 9.16 49.8  11.2 29.8 69.2
6 113.8  7.3 19.1  3.9 14.7  2.3 0.77  0.10 7.69  0.56 6.71 8.00 52.5  9.6 36.1 69.4
7 119.3  6.1 22.6  3.6 15.9  2.1 0.86  0.08 7.85  0.59 6.95 8.85 57.4  9.6 41.2 70.2
8 123.5  7.6 24.8  4.1 16.3  1.9 0.92  0.10 7.95  0.60 7.09 9.07 60.3  12.0 44.0 84.2
9 125.9  6.5 24.8  4.0 15.6  1.9 0.93  0.09 8.07  0.63 7.11 9.08 63.4  12.1 47.0 80.4
10 130.5  7.7 27.3  4.7 16.0  1.8 0.99  0.11 8.27  0.67 7.28 9.34 66.3  13.9 43.8 87.7
11 135.0  5.9 29.5  3.8 16.2  1.3 1.05  0.09 8.37  0.61 7.31 9.70 69.4  13.2 47.6 88.5
12 139.5  6.6 32.1  4.6 16.5  1.7 1.11  0.10 8.54  0.65 7.80 9.74 73.6  13.4 53.4 97.9
13 145.9  9.7 35.6  5.6 16.7  1.7 1.20  0.12 8.81  0.66 7.69 9.90 78.9  13.6 59.4 105.7

Table 3. Multivariate regression analysis showing the relationship between liver, spleen, and kidney dimensions with age, height,
weight, BMI, or BSA.

All (n ¼ 1000) Girls (n ¼ 500) Boys (n ¼ 500)

Variables â* P value â* P value â* P value

Liver span
Age 0.079 0.070 0.060 0.272 0.099 0.120
Height 0.167 0.027 0.194 0.061 0.140 0.207
Weight –0.367 0.047 –0.420 0.097 –0.292 0.293
BMI –0.066 0.048 –0.076 0.109 –0.059 0.205
BSA 0.524 <0.001 0.472 <0.001 0.472 <0.001
Spleen length
Age 0.130 0.016 0.161 0.044 0.103 0.067
Height 0.318 <0.001 0.352 <0.001 0.116 0.043
Weight 0.088 0.158 0.060 0.031 –0.237 0.432
BMI 0.049 0.117 0.035 0.428 –0.047 0.350
BSA 0.121 0.149 0.081 0.492 0.2911 <0.001
Kidney dimensions Right kidney Left kidney Right kidney volume Left kidney volume
(prone)

â* P value â* P value â* P value â* P value

Age 0.119 0.004 0.088 0.042 0.101 0.007 0.050 0.193

Height 0.284 <0.001 0.269 <0.001 0.205 0.002 0.188 0.005
Weight –0.468 0.008 –0.511 0.005 –0.338 0.034 –0.380 0.021
BMI –0.143 <0.001 –0.131 <0.001 –0.103 0.001 –0.087 0.003
BSA 0.585 <0.001 0.531 <0.001 0.679 <0.001 0.652 <0.001
*Standardized coefficients of regression.
BMI, body mass index (kg/m2); BSA, body surface area (m2).
6 Acta Radiologica 0(0)
Table 4. Simple regression formula for the liver, spleen, and kidney (prone) dimensions using the body size indicators based on the
best model.
Dimensions
Liver span (cm) Girls
Boys
Splenic length (cm) Girls
Boys
Kidney length (cm) Right
Left
Kidney volume (cm3) Right
Left
BSA, body surface area; H, height.
difference in physique, which is one of the factors that
determines liver dimensions in people.
On multivariate analysis, the liver span was found to
correlate significantly with BSA and BMI. This is sim-
ilar to the report from southeast Nigeria in which BSA
correlated the most with the liver dimensions followed
by weight (12). BSA and BMI have, however, been
reported to correlate inconsistently with liver dimen-
sions by some other researchers outside of Nigeria
(17–19). Height and weight have also been found by
many other researchers to correlate significantly with
liver dimensions (18–20).
The splenic size in the present study did not consis-
tently increase with age. A researcher reported a similar
finding in the relationship of splenic length with age
among Sudanese children (11). This is contrary to ear-
lier reports from southeast Nigeria that showed an
increase in splenic size with age in both sexes (12).
Salam et al. (1) also reported an increase in splenic
size with increasing age in a study carried out in
Egypt. Age, therefore, may not be used in predicting
splenic length among children from the southwestern
part of Nigeria. This difference might be due to genetic
factors.
The splenic length in the present study is lower than
that reported among children from southeastern
Nigeria (12), Sudan (11), and Pakistan (14). This is
evidence of ethnic and racial differences. Ezeofor and
other researchers reported significantly larger spleen
dimensions in boys (5,12,22); this is in agreement
with the finding in the present study. Nouri et al.
(11), however, reported a larger splenic dimension in
female Sudanese children compared with their male
counterparts. However, some studies did not report
any sexual dimorphism in splenic dimensions (17–21).
On multivariate analysis, height correlated best with
splenic length in the present study followed by age;
however, BSA was found to correlate best among chil-
dren from the southeast of Nigeria (12). Salam et al. (1)
is in agreement with the present study: they reported
Formulae Adjusted R2
¼ (7.75) þ (0.567) BSA 0.320
¼ (8.30) þ (0.472) BSA 0.223
¼ (3.85) þ (0.042) H 0.122
¼ (4.38) þ (0.040) H 0.081
¼ (5.68) þ (2.58) BSA 0.342
¼ (5.86) þ (2.59) BSA 0.281
¼ (5.14) þ (61.33) BSA 0.461
¼ (2.42) þ (69.13) BSA 0.425
that height showed the best correlate with splenic
length. In an earlier study among Nigerian adults
from the southeast, Ehimwenma and Tagbo (22)
reported weight as the best correlate. Physique and
diet may be responsible for these differences.
It is well-known that kidney size is related to age,
height, and weight. The present study also shows a sig-
nificant relationship between kidney parameters and
anthropometric measures. Some studies have shown
that height correlates best with kidney length (23–27)
while others revealed that weight is the best correlate
with kidney length. In the present study, however, BSA
correlates best with kidney length and volume, fol-
lowed by weight and height.
It is believed that, after a wide search, no easy-to-use
bedside formula for the assessment of these organs has
been generated. Therefore, a regression equation
for estimating the dimensions of these organs was for-
mulated based on the best multivariate correlates for
each organ.
The present study has some limitations. First, the
study was carried out in a limited geographical loca-
tion; hence, a multicenter international collaboration
with larger sample size may be advised to further val-
idate the strength of the regression formulae in chil-
dren, especially those outside the study location. It is
also worth noting that the study was carried out among
children attending public schools. This may have
skewed the study population towards children from
homes with a low and middle socioeconomic status.
A further study that is more inclusive will be advocat-
ed. In the same vein, blood and urine samples may have
been collected to screen the children for subclinical
abnormalities in the studied organs.
In conclusion, the nomograms generated from the
present study and the formulated regression equation
can be referred to when assessing these organs for
pathology especially among children from the south-
west of Nigeria. Further studies in other centers will
be necessary in others to identify the factors
Akinlade et al.
responsible for the differences in organ dimensions of
children in southeast and southwest Nigeria
Acknowledgements
The authors thank Akinlade Olawale Mathias for his assis-
tance during the execution phase of the project and write-up.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
ORCID iDs
Folasade T Akinlade https://orcid.org/0000-0002-2579-
7461
Oluwagbemiga O Ayoola https://orcid.org/0000-0002-
7832-3390
References
1. Salam GA, Mehlab E, Ali MA. Ultrasonographic
Estimation of Age-Dependent Changes in Length of
Spleen and Hepatic Lobes and Diameters of Portal
Vein and Common Bile Duct in Children. Journal of
American Sciences 2013;9:31–39.
2. Eze CU, Agwu KK, Ezeasor DN, et al. Sonographic
biometry of spleen among school age children in
Nsukka, Southeast, Nigeria. Afr Health Sci
2013;13:384–392.
3. Gameraddin M, Ali AP, Al-radaddi M, et al. The
Sonographic Dimensions of the Liver at Normal
Subjects Compared to Patients with Malaria. Int J Med
Imaging 2015;3:130.
4. Megremis SD, Vlachonikolis IG, Tsilimigaki AM. Spleen
Length in Childhood with US: Normal Values Based on
Age, Sex, and Somatometric Parameters. Radiology
2004;231:129–134.
5. Da Silva RM, Pereira RB, Siqueira MV. Correlation
between clinical evaluation of liver size versus ultraso-
nography evaluation according to body mass index
(BMI) and biotypes. Rev Med Chil 2010;138:1495–1501.
6. Kratzer W, Fritz V, Mason RA, et al. Factors Affecting
Liver Size: A Sonographic Survey of 2080 Subjects. J
Ultrasound Med 2003;22:1155–1161.
€
7. Ozmen €
Z, Aktaş F, Ozmen Z, et al. Ultrasound measure-
ment of liver longitudinal length in a North Anatolian
population: A community-based study. Niger J Clin
Pract 2018;21:653.
8. Safak AA, Simsek E, Bahcebasi T. Sonographic assess-
ment of the normal limits and percentile curves of liver,
spleen, and kidney dimensions in healthy school-aged
children. J Ultrasound Med 2005;24:1359–1364.
7
9. Buchholz NP, Abbas F, Biyabani SR, et al.
Ultrasonographic renal size in individuals without
known renal disease. J Pak Med Assoc 2000;50:12–16.
10. Atalabi OM, Orimadegun AE, Adekanmi AJ, et al.
Ultrasonographic renal sizes, cortical thickness and
volume in Nigerian children with acute falciparum malar-
ia. Malar J 2013;12:92.
11. Nouri M, Ayad CE, Balla A, et al. Establishment Local
Reference of Spleen Length in Sudanese Normal School
Age Children Sonographically. Global Journal of
Medical Research 2013;13:18–24.
12. Ezeofor S, Obikili E, Anyanwu G, et al. Sonographic
assessment of the normal limits of the spleen in healthy
school children in South-East Nigeria. Niger J Clin Pract
2014;17:484–488.
13. Okoye I, Agwu K, Ochie K. Sonographic splenic sizes in
normal adult Nigerian population. West African J Radiol
2006;12:37–43.
14. Raza F, Hussain S, Bhugio S, et al. Normative data of
hepato-splenic sizes in Pakistani pediatric population
using ultrasonography. Pakistan Journal of Medicine
and Dentistry 2014;3:36–42.
15. Eze CU, Agwu KK, Ezeasor DN, et al.
Sonographic biometry of liver size among Igbo school
age children of South east, Nigeria. Radiography
2013;19:228–233.
16. Warnakulasuriya DTD, Peries PPUC, Rathnasekara
YAC, et al. Ultrasonographic parameters of the liver,
spleen and kidneys among a cohort of school children
in Sri Lanka. BMC Pediatr 2017;17:192.
17. Dhingra B, Sharma S, Mishra D, et al. Normal values of
liver and spleen size by ultrasonography in Indian chil-
dren. Indian Pediatr 2010;47:487–492.
18. Soyupak SK, Narl N, Yapcolu H, et al. Sonographic
measurements of the liver, spleen and kidney dimensions
in the healthy term and preterm newborns. Eur J Radiol
2002;43:73–78.
19. Safak AA, Simsek E, Bahcebasi T. Sonographic assess-
ment of the normal limits and percentile curves of
liver, spleen, and kidney dimensions in healthy school-
aged children. J Ultrasound Med 2005;24:1359–1364.
20. Nemati M, Hajalioghli P, Jahed S, et al. Normal values
of spleen length and volume: An ultrasonographic
study in children. Ultrasound Med Biol
2016;42:1771–1778.
21. Pelizzo G, Guazzotti M, Klersy C, et al. Spleen size eval-
uation in children: Time to define splenomegaly for pedi-
atric surgeons and pediatricians. PLoS One 2018;13:
e0202741.
22. Ehimwenma O, Tagbo M. Determination of normal
dimension of the spleen by ultrasound in an endemic
tropical environment. Niger Med J 2011;52:198–203.
23. Oh MS, Hwang G, Han S, et al. Sonographic growth
charts for kidney length in normal Korean children: A
prospective observational study. J Korean Med Sci
2016;31;1089–1093.
24. Sulaiman Aloraini A, Mekbel Aldahmashi A.
Sonographic Dimensions of Normal Kidney Among
Children. Egypt J Hosp Med 2018;70:855–858.
8 Acta Radiologica 0(0)

25. Duminda WD, Pathirana KG, Fernando MUJ, et al.
Ultrasonographic length of morphologically-normal kid-
neys in children presented to a premier tertiary healthcare
setting of Sri Lanka. BMC Nephrol 2019;20:183.
26. Kim JH, Kim MJ, Lim SH, et al. Length and volume of
morphologically normal kidneys in Korean children:
Ultrasound measurement and estimation using body
size. Korean J Radiol 2013;14:677–682.
27. Otiv A, Mehta K, Ali U, et al. Sonographic measurement
of renal size in normal Indian children. Indian Pediatr
2012;49:533–536.