Diagnostic Ultrasound - Abdomen and Pelvis

Splenic Infarct
(Left) Power Doppler US of the
spleen in longitudinal plane
shows a central, welldemarcated,
wedge-shaped
area of relative
hypoechogenicity . There is
diminished (but not absent)
power Doppler signal within
the area of infarct ſt. (Right)
Corresponding coronal CECT in
a patient with end-stage liver
disease with portal
hypertension marked by
massive ascites and
splenomegaly with central
infarct . Streak artifact
from metallic embolization
coils present ſt (therapeutic
splenic artery emobilization).
Diagnoses: Spleen
(Left) Rounded polar splenic
infarct is shown on grayscale
US. The infarcted area is
hypoechoic and welldemarcated
. Color Doppler
(not shown) demonstrated
absent flow. (Right) A mimic of
splenic infarction is splenic
laceration, shown here as a
well-defined, hypoechoic,
band-like area extending
to the subcapsular region. The
history of trauma is an
important differentiating
factor. The spleen is the most
frequently injured
intraperitoneal organ in
patients with blunt abdominal
trauma.
(Left) Axial NECT shows a
heavily calcified and
heterogeneous spleen ſt,
indicating chronic, and
possibly acute, infarction.
(Right) The splenectomy
specimen shows a mottled
spleen with capsular
discoloration st that was
heavily calcified on
microscopy.
417