Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Splenic Sonography
(Left) Longitudinal oblique US
in a patient with splenomegaly
shows the spleen from a
lateral intercostal approach (a
conventional "long" plane).
(Right) Conventional
transverse US in the same
patient shows the spleen from
the lateral intercostal
approach.
Diagnoses: Spleen
(Left) For comparison, a
conventional "long"
(longitudinal oblique) US in
the same patient shows the
spleen from an
anterior/anterolateral oblique
subcostal approach. This view
is often limited by bowel gas,
but was possible in this
patient due to splenomegaly.
(Right) Corresponding
conventional transverse US in
the same patient shows the
spleen from an anterior
oblique subcostal approach.
(Left) True transverse plane
(anatomic transverse slice
through hilum) in the same
patient, from anterior oblique
subcostal approach, shows a
triangular splenic shape rather
than the crescent shape seen
in the conventional transverse
plane. (Right) True transverse
US of the spleen from the
intercostal approach (90° turn
of the transducer rather than
usual 180°) in the same
patient is shown. Note the
limitations caused by the ribs,
resulting in posterior acoustic
shadowing ſt, one reason
why the true transverse plane
is not traditionally used.
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