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Factors Affecting Liver Size

A Sonographic Survey of 2080 Subjects

Abteilung Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany.

Address correspondence and reprint requests to Wolfgang Kratzer, MD, Abteilung Innere Medizin I, Universität Ulm, Robert-Koch-Strasse 8, 89081 Ulm, Germany. E-mail: wolfgang.kratzer{at}medizin.uni-ulm.de.

Objective. We sought to determine the size of the liver in a nonselected population sample to establish normal and reference values and to study potential factors influencing liver size. Methods. A total of 2080 subjects (983 male and 1097 female; age range, 18–88 years) underwent prospective ultrasound examination to determine the size of the liver. Subjects also underwent physical examination and completed a short standardized interview questionnaire covering potential factors influencing liver size. Data were evaluated descriptively. The influence of multiple variables on liver size was studied by means of a covariance analysis. Results. The average measured liver diameter (midclavicular line) ± SD was 14.0 ± 1.7 cm (median, 13.9 cm; range, 9.4–21.3 cm; average in male subjects, 14.5 ± 1.6 cm; and average in female subjects, 13.5 ± 1.7 cm). Results of the multivariate analysis showed that the factors body mass index, body height, sex, age, and (in male subjects) frequent alcohol consumption exert an influence over liver size measured at the midclavicular line. Conclusions. The sonographic measurement of liver size at the midclavicular line was shown to be an easy and practical method for routine use. Only in 239 (11.5%) of 2080 subjects did the size of the liver measured at the midclavicular line exceed 16 cm. Body mass index and body height are the most important factors associated with the diameter of the liver measured at the midclavicular line.

Abbreviations: BMI, body mass index • MCL, midclavicular line

Key Words: alcohol • body height • liver • normal value • size • sonography