Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Splenic Sonography
Diagnoses: Spleen
(Left) Axial CECT through the
left upper quadrant shows the
anatomic factors which may
limit visualization of the
spleen: Posteriorly, the left
lung base; anteriorly, the
stomach ; and from all
directions, the ribs st. Note
also the simple cyst in the
posterior, superior spleen .
(Right) A few centimeters
more caudally (same case),
note the optimal acoustic
window that can be obtained
from lateral intercostal
approach, between ribs 9 and
10 , or posterolateral
intercostal approach, between
ribs 10 and 11 .
(Left) Conventional
"longitudinal spleen" US from
lateral intercostal approach is
shown. In actuality, this is a
longitudinal oblique view.
Note superior position of the
cyst , left hemidiaphragm
ſt, and stomach . Calipers
measure spleen length. (Right)
Conventional "transverse
spleen" US is shown in the
same patient. In actuality, this
is almost a mirror image of the
longitudinal oblique view.
Note the position of the cyst
, left hemidiaphragm ſt,
and stomach . Calipers
measure spleen thickness.
(Left) Oblique reformatted CT
corresponding to the
conventional "longitudinal
spleen" US is shown. Note the
position of the cyst , the left
lung base ſt, and the stomach
. A transducer would be
positioned here . (Right) For
comparison, sagittal CT
through the spleen shows the
oblique orientation of the
organ with respect to the
longitudinal (sagittal) axis of
the body. Note the superior
position of the splenic cyst
and the positions of the
stomach and left
diaphragm ſt.
396