SPLEEN

ULTRASOUND

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 REVIEW OF THE ANTOMY
 The spleen is the organ that is responsible for both the storage and
purification of red blood cells.

 The spleen is an organ crescent-shaped organ that lies relative to the 9th
and 11th ribs and is located in the left hypochondrium and partly in the
epigastrium. Thus, the spleen is situated between the fundus of
the stomach and the diaphragm.
http://www.webmd.com/digestive-
disorders/picture-of-the-spleen

http://www.healthline.com/human-body-maps/spleen

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 INDICATION

 Asses splenic size

 Detect presence of masses
 Asses size of portal vein
 Assessing splenic damage from blunt trauma such as rupture
or hemorrhage.

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 PREPARATION

• The patient should take nothing by mouth for 6 to 8

hours for adults and 3-4 hours for infants preceding
the examination.
• 3.5 MHz transducer for adults and 5MHz for children

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 SONOGRAPHIC APPEARANCE

Spleen

Comparison of Liver and Spleen parenchyma.

 The echostructure of the spleen is homogenous, finer or smooth texture.

It should be the same (isoechoic) or slightly hyperechoic, with mild-to-low
echogenicity relative to hepatic parenchyma.

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 SONOGRAPHIC APPEARANCE
 The shape of the spleen visualized
Diaphragmatic side using ultrasonography is that of a
bean or of an orange slice.

 The spleen is an encapsulated

Spleen Parenchyma structure and has a smooth contour.
The splenic capsule appears as a
fine, hyperechoic line that envelops
the parenchyma of the spleen.
Visceral side

 The diaphragmatic side of the

spleen is concave, while the visceral
side is convex or linear, sometimes
with an irregular border.

 The visceral side contains the

Splenic capsule splenic hilum, which contains the
splenic vessels with hyperechoic
walls.

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 SONOGRAPHIC APPEARANCE
Splenic Hilum
 The hilum of the spleen is located on the inferomedial part of the gastric
impression and contains the splenic vessels and nerves.

http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch08-spleen.pdf

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 SONOGRAPHIC APPEARANCE
Accessory Spleen
 A supernumerary spleen (also known as splenule or splenunculus)
represents normal splenic tissue, separated from the spleen. It has no
pathological significance.

http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch08-spleen.pdf

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 SCANNING TECHNIQUE
 Scan the patient in the supine,
lateral and oblique positions.

 Scan from below the costal

margin, angling the beam
towards the diaphragm, then in
the ninth intercostal space
downwards.

 Also perform longitudinal from

anterior to posterior axillary
lines and transverse upper
abdominal scan.

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 SCANNING TECHNIQUE

http://www.ultrasoundpaedia.com/normal-spleen/

Intercostal scan plane Normal Spleen

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 SIZE
Spleen Long Axis 12-13 cm

Spleen Depth 7-8 cm

Spleen Width 6-7 cm

Splenic Volume 60-200 ml

Splenic Index 107-314 cm3

Sonographic measurement of the spleen. D1

indicates length; D2, width.

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 SPLENIC INDEX

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 PATHOLOGY
SPLENOMEGALY
 The most common splenic abnormality .
 It is defined by increased splenic dimensions and volume. Spleen
longitudinal and transverse diameters averaged over 13 cm, respectively over
5 cm are considered splenomegaly.
http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch08-spleen.pdf

Case of splenomegaly in which the upper pole of the

spleen touches the left lobe of the liver (arrow).

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 PATHOLOGY
SPLENIC HEMANGIOMA
A hemangioma is the most common benign tumor of the spleen and
typically does not exceed 2 cm in size. They look like hyperechogenic bright
areas.

https://www.studyblue.com/notes/note/n/exam-2/deck/2586602

Hyperechogenic bearing is marked by a circle

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 PATHOLOGY
SPLENIC VEIN IN PORTAL
HYPERTENSION
In chronic cirrhotic liver disease oblituation of the portal vessels
results in reversal of blood flow to the splenic vein.

Dilated splenic vein in the hilum

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 References

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