Tuesday May 22 , 2012
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Ultrasound - Spleen

ULTRASOUND OF THE SPLEEN

Alternative Names:  spleen ultrasound, spleen sonography, ultrasound of the spleen

ULTRASOUND PATIENT POSITION FOR THE SPLEEN

  • Start with the patient in the supine position.

  • Angle the probe between the ribs intercostally posterolaterally.

  • Overlying bowel gas, overlying lung base or rib shadows can cause problems. Slowly roll the patient, to improve visualistaion.

  • Try inspiration,expiration,distended abdomen,erect

  • Rarely the left lobe of the liver (if enlarged) may be used as a window to assess to superoanterior portion of the spleen.

ULTRASOUND APPEARANCES OF THE SPLEEN

The spleen has a homogeneous, "inverted comma" appearance.

Size:  When it becomes enlarged it loses this shape and as it expands it becomes very rounded and sometimes appears as an egg shape extending beyond the Left kidney.

NORMAL ADULT MEASUREMENTS

  • Normal is <12-14cm adult (or Volume <400/500cc).

  • The spleen is enlarged if it covers the entire left kidney

PATHOLOGY

  • Splenomegaly >12-14 cm (or Volume >500cc)and becomes rounded.

  • Infection- multiple echogenic foci (granulomata)

  • Haemangioma

  • Cysts

  • Metastases

  • Lymphoma

  • Varices - portal hypertension

  • Haematomas-intraparenchymal, subcapsular and pericapsular

  • Abscess

  • Splenic infarction

  • Normal variants:

  • Accessory spleen (splenunculi)- can appear at the site of the pancreatic tail, the inferior pole of spleen or in the splenic hilum.It can be mistaken for a mass or lymph node.

  • Asplenia (no spleen)

  • Polysplenia (>1)

SPLEEN ULTRASOUND SAMPLE PROTOCOL (TYPICALLY)

This sample protocol is meant for educational purposes and the exact technique will depend on the patient's clinical indication for the examnation and the radiologist's guidance.

 Document the normal anatomy. Any pathology found in 2 planes, including measurements and any vascularity.

  1. Longitudinal image of the spleen and measure from superior to inferior

  2. Transverse image of the spleen and measure width, left to right LIVER: 8 images-4 in each plane

  3. Use doppler imaging to determine the presence and direction of flow in the splenic vein and artery

Schedule Your Spleen Ultrasound Today!

  • If you are looking for professional radiology services at your imaging site/center, call us at 1-800-626-8315 or contact us for a consultation. 

  • If you live in Los Angeles, Century City, Glendale, Mid-Wilshire and need to schedule a radiology examination such as a MRI, CT Scan, Ultrasound, X ray, or PET scan, contact us to schedule an appointment. 

  • If you are in search of other things, we're surprisingly resourceful!  Call us 1-800-626-8315 or contact us via our contact form.