Sonographic Correlation between objective spleen parenchymal echotexture and Hematological parameters in children with sickle cell disease

Abstract

Background: Children with sickle cell disease (SCD) are frequently evaluated for spleen involvement using laboratory markers and subjective ultrasound interpretation. Quantitative ultrasound echotexture analysis could offer an objective way to assess spleen parenchymal alterations. Although its relationship with hematological markers of spleen function is not well established.

Aim: The study assessed the relationship between selected hematological parameters and quantitative ultrasonography spleen parenchymal echotexture in children with sickle cell disease.

Methods: In this cross-sectional study, children with SCD underwent standardized B-mode ultrasound scan of the spleen. Quantitative echotexture measures, including mean pixel intensity (MPI), were extracted from defined regions of interest using a validated MATLAB algorithm. Hematological parameters; white blood cell (WBC) count, red blood cell (RBC) count, and platelet count were obtained on the same day. Pearson correlation coefficients were used for analysis.

Results: Mean Pixel Intensity showed a statistically significant moderate positive correlation with WBC count (r = 0.53, p = 0.002). Correlations between MPI and RBC count (r = 0.09, p = 0.58), platelet count (r = 0.18, p = 0.27) were weak and not statistically significant.

Conclusion: Quantitative spleen echotexture, assessed via pixel intensity analysis, is meaningfully associated with WBC count in children with SCD. Mean pixel intensity may serve as a promising non-invasive imaging biomarker, complementing hematological assessment and enhancing the objectivity of spleen ultrasound evaluation.