Diagnostic Ultrasound - Abdomen and Pelvis
Spleen SPLENIC VESSELS Anatomy: Abdomen Splenic vein Splenic artery Segmental arterial branches Splenic artery Splenic vein (Top) Longitudinal oblique color Doppler ultrasound demonstrates the branching of the splenic arteries and veins in the splenic hilum. (Middle) Spectral Doppler waveform of the distal splenic artery at the splenic hilum is shown. Because of a tortuous course, flow in this vessel is typically turbulent. The splenic artery has a low-resistance waveform (ample flow throughout diastole). Normal peak systolic velocity for the splenic artery is 25-45 cm/sec. (Bottom) Spectral Doppler waveform ultrasound of the splenic vein at the hilum shows a typical band-like flow profile with minimal respiratory fluctuations; flow is directed away from the transducer (away from the spleen). Normal peak systolic velocity of the splenic vein is 9-18 cm/sec. 35
Spleen Anatomy: Abdomen ANATOMICAL VARIANTS Splenule Spleen Accessory splenic vessels supplying splenule Stomach Spleen Splenic artery Splenic vein Pancreas Accessory vessels supplying splenule Left kidney Splenule Splenic cyst Heart Spleen in right upper quadrant Right diaphragm Ascites Right kidney (Top) Longitudinal oblique intercostal color Doppler ultrasound shows a splenule adjacent to the spleen tip. Splenules should have the same echogenicity and echotexture as the spleen, though this may depend on the sonographic window. The identification of vascular supply from the splenic vessels may also aid in identification of a splenule. (Middle) Correlative coronal CECT of the left upper quadrant demonstrates a splenule along the inferior tip of the spleen. Branch vessels from the splenic artery and vein supplying the splenule are visualized. (Bottom) Longitudinal oblique ultrasound of the right upper quadrant in a patient with heterotaxy syndrome (situs ambiguus) demonstrates a right-sided spleen. The classification of heterotaxy syndromes is complex; there is a spectrum ranging from classic asplenia to classic polysplenia. Heterotaxy with polysplenia (i.e., left double-sidedness or left isomerism) may present with multiple spleens (resembling splenules) or a single spleen, as in this case. 36
- Page 6 and 7: Dedications To my sweet and support
- Page 8 and 9: Asef Khwaja, MD Assistant Professor
- Page 10 and 11: Preface
- Page 12 and 13: Acknowledgements Text Editors Nina
- Page 14 and 15: Sections PART I - Anatomy SECTION 1
- Page 16 and 17: TABLE OF CONTENTS VASCULAR CONDITIO
- Page 18 and 19: TABLE OF CONTENTS 562 Perigraft Flu
- Page 20 and 21: TABLE OF CONTENTS 906 Hyperechoic G
- Page 22 and 23: Diagnostic Ultrasound
- Page 24 and 25: PART I SECTION 1 Abdomen Liver 4 Bi
- Page 26 and 27: Liver ○ Appear as echolucent defe
- Page 28 and 29: Liver Coronary ligament HEPATIC ATT
- Page 30 and 31: Liver Segment 8 HEPATIC SEGMENTS Se
- Page 32 and 33: Liver Rectus abdominis muscle LEFT
- Page 34 and 35: Liver Abdominal muscle LEFT LOBE OF
- Page 36 and 37: Liver Anterior right portal vein RI
- Page 38 and 39: Liver PORTA HEPATIS Anatomy: Abdome
- Page 40 and 41: Liver Inferior liver margin OTHER V
- Page 42 and 43: Biliary System • Harmonic imaging
- Page 44 and 45: Biliary System Left hepatic duct Ri
- Page 46 and 47: Biliary System Right rectus muscle
- Page 48 and 49: Biliary System COMMON BILE DUCT Ana
- Page 50 and 51: Biliary System LEFT INTRAHEPATIC DU
- Page 52 and 53: Spleen SPLEEN ANATOMY AND HISTOLOGY
- Page 54 and 55: Spleen Fat in splenic hilum Left he
- Page 58 and 59: Spleen Splenosis ANATOMICAL VARIANT
- Page 60 and 61: Pancreas PANCREAS IN SITU Anatomy:
- Page 62 and 63: Pancreas PANCREAS, TRANSVERSE VIEW
- Page 64 and 65: Pancreas Left lobe of liver PANCREA
- Page 66 and 67: Kidneys - Normal peak systolic velo
- Page 68 and 69: Kidneys KIDNEY ARTERIES AND INTERIO
- Page 70 and 71: Kidneys RENAL FASCIA AND PERIRENAL
- Page 72 and 73: Kidneys Right hemidiaphragm RIGHT K
- Page 74 and 75: Kidneys RIGHT KIDNEY, CT CORRELATIO
- Page 76 and 77: Kidneys Right erector spinae muscle
- Page 78 and 79: Kidneys RIGHT INTRARENAL ARTERY AND
- Page 80 and 81: Kidneys LEFT KIDNEY, CT CORRELATION
- Page 82 and 83: Kidneys LEFT KIDNEY, CT CORRELATION
- Page 84 and 85: Kidneys Subcutaneous fat Left latis
- Page 86 and 87: Kidneys LEFT MAIN RENAL ARTERY AND
- Page 88 and 89: Kidneys Right lobe of liver MULTIPL
- Page 90 and 91: Bowel - Forms an incomplete ring in
- Page 92 and 93: Bowel Falciform ligament STOMACH AN
- Page 94 and 95: Bowel SMALL INTESTINE Anatomy: Abdo
- Page 96 and 97: Bowel Abdominal wall STOMACH Anatom
- Page 98 and 99: Bowel Rectus muscle SMALL BOWEL Ana
- Page 100 and 101: Bowel Abdominal wall musculature Ce
- Page 102 and 103: Bowel LARGE BOWEL Abdominal wall mu
- Page 104 and 105: Bowel Urinary bladder RECTOSIGMOID
Spleen<br />
Anatomy: <strong>Abdomen</strong><br />
ANATOMICAL VARIANTS<br />
Splenule<br />
Spleen<br />
Accessory splenic vessels supplying<br />
splenule<br />
Stomach<br />
Spleen<br />
Splenic artery<br />
Splenic vein<br />
Pancreas<br />
Accessory vessels supplying splenule<br />
Left kidney<br />
Splenule<br />
Splenic cyst<br />
Heart<br />
Spleen in right upper quadrant<br />
Right diaphragm<br />
Ascites<br />
Right kidney<br />
(Top) Longitudinal oblique intercostal color Doppler ultrasound shows a splenule adjacent to the spleen tip. Splenules should have the<br />
same echogenicity <strong>and</strong> echotexture as the spleen, though this may depend on the sonographic window. The identification of vascular<br />
supply from the splenic vessels may also aid in identification of a splenule. (Middle) Correlative coronal CECT of the left upper quadrant<br />
demonstrates a splenule along the inferior tip of the spleen. Branch vessels from the splenic artery <strong>and</strong> vein supplying the splenule are<br />
visualized. (Bottom) Longitudinal oblique ultrasound of the right upper quadrant in a patient with heterotaxy syndrome (situs<br />
ambiguus) demonstrates a right-sided spleen. The classification of heterotaxy syndromes is complex; there is a spectrum ranging from<br />
classic asplenia to classic polysplenia. Heterotaxy with polysplenia (i.e., left double-sidedness or left isomerism) may present with<br />
multiple spleens (resembling splenules) or a single spleen, as in this case.<br />
36
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