Diagnostic Ultrasound - Abdomen and Pelvis

Splenic Cyst
(Left) Grayscale US of the
spleen shows an incidental 8
mm, anechoic splenic cyst ſt.
Note the posterior acoustic
enhancement and welldefined
back wall ,
confirming the cystic nature of
this lesion. (Right) Color
Doppler US in the same
patient confirms that this
lesion is avascular and indeed
a splenic cyst. Rarely, splenic
pseudoaneurysms may mimic a
splenic cyst on grayscale
imaging; color Doppler
imaging is therefore important
to distinguish the 2 entities.
Diagnoses: Spleen
(Left) Transverse grayscale US
of the spleen shows a
multiloculated cyst with a
cyst-within-cyst appearance.
The contents of the cyst are
anechoic . Partial
curvilinear calcification ſt is
seen in the cyst wall. This
represents a chronic, healed
hydatid cyst. (Right) Color
Doppler US shows a pyogenic
splenic abscess, seen as a welldefined
solitary avascular
lesion with a hypoechoic
necrotic center ſt and a thick
irregular wall st. Note
surrounding splenic
parenchymal vessels displaced
by the abscess .
(Left) Grayscale US shows a
large, hypoechoic, splenic
complex cystic lesion st,
proven to be a pyogenic
abscess by percutaneous
drainage. Note the irregular
shape and multiplicity ,
which may help differentiate
this from a simple cyst. (Right)
Color Doppler US in a patient
with leukemia shows a splenic
infarct, which may mimic a
cyst. Note the avascularity,
peripheral wedge-shaped
(rather than spherical)
configuration, and echogenic
fine internal bands ,
characteristic of splenic
infarct.
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