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Spleen Ultrasound PowerPoint Presentation

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Description : The spleen should have a uniform homogenous echo pattern.

Tags : radiology,ultrasound

Published on : Oct 27, 2023 | Views : 702 | Downloads : 0

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Slide 1-

Spleen Ultrasound
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Splenomgaly Blunt abdominal trauma Left abdominal mass Left upper abdominal pain Jaundice with anemia Ascites Suscpected subphrenic abscess Suspected malinancy Common indications
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Normal position Best assessed in the supine, right lateral position with the left arm placed behind the head Visualized best obliquely in the 9th or 10th intercostal spaces
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Sonographic appearance of normal spleen The spleen should have a uniform homogenous echo pattern. It is slightly less echogenic than the liver. Markedly hyperechoic compared to kidney tissue Its outer convexity is smooth and inner margin may be indented or nodulous.
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Common pathologies of the spleen Splenomegaly Infection- Multiple echogenic foci (granuloma) Hemangioma Cyst Lymphoma Varices- Portal hypertension Hematoma Abscess Infarction
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Splenomegaly Splenomegaly refers to enlargement of the spleen. The upper limit of the normal adult splenic length is 12 cm. Massive splenomegaly is variably defined, including When the spleen is 5 standard deviations above the mean normal volume (~943 cm3) heavier than 1.5 kg >14.5 cm true craniocaudal measurement on coronal CT >15 cm on clinical exam or at/below the umbilicus, extending into the pelvis and/or across the midline On ultrasound the prolate ellipsoid formula is used most commonly 13: spleen volume (cm3) = 0.52 × length × anteroposterior dimension × width (cm)
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Splenic hemangioma Most common primary benign neoplasm of the spleen. According to newer nomenclature (ISSVA classification of vascular anomalies) these lesions are known as slow flow venous malformations. The dominant pattern is considered to be a homogeneous echotexture that is predominantly hyperechoic. Usually does not demonstrate any intrinsic color flow (~80% of cases) Calcification (either central punctate or peripheral curvilinear) Associations Splenic Haemangiomatosis: The Presence Of Multiple Splenic Hemangiomas Splenic manifestations of a systemic angiomatosis syndrome such as Klippel-Trénaunay-Weber syndrome Beckwith-Wiedemann syndrome
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Hemangioma
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Splenic abscess Poorly-demarcated Hypoechoic with some internal echoes to hyperechoic The main causes of splenic abscesses include: Immunodeficiency conditions:- especially in those with multiple splenic abscesses Infection: splenic infarction with superimposed infection Trauma
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Splenic trauma Subcapsular splenic hematomas are a type of splenic hematoma that occurs beneath the splenic capsule. Mostly hypoechoic subcapsular splenic collection.
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Splenic infarction Infarcts are hypoechoic compared to the rest of the spleen As the infarct matures:- If it undergoes contraction and scarring it will appear as a hyperechoic region with retraction of the capsule. If liquefaction occurs, the area may be rounded and anechoic (splenic pseudocyst). Liquefaction
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Granuloma Splenic granulomatous disease refers to sequelae arising from granulomatous infection-inflammation of the spleen. Hyperechoic foci with posterior acoustic shadow. Causes:- Infective Splenic tuberculosis Splenic histoplasmosis Splenic brucellosis Non-infective Splenic sarcoidosis
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Splenic cyst Splenic epithelial cysts are unilocular anechoic to hypoechoic well defined intrasplenic fluid lesions with thin and smooth walls and no enhancement. Internal echoes may be present due to debris. Their margin may be echogenic with distal shadowing due to calcifications
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Splenic lymphoma Most common malignancy to involve the spleen. 30% of all Hodgkin lymphoma and 30-40% of patients with systemic non-Hodgkin lymphoma (NHL) Focal disease manifest as small circumscribed nodules, sometimes referred as a miliary pattern Bulky hypoechoic splenic masses A diffuse infiltrative disease is usually characterized as an enlarged spleen only.
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