Diagnostic Ultrasound - Abdomen and Pelvis

Focal Splenic Lesion
Splenic Infarct
Splenic Infarct
(Left) Color Doppler US shows
a splenic infarct,
predominately anechoic. This
can mimic a cyst or
hematoma; take note of the
shape (peripheral, wedge-like)
with a few parallel echogenic
bands (bright band sign)
more characteristic of infarct.
(Right) US shows a small
spleen an with irregular
contour. Multiple cystic areas
ſt with echogenic bands are
present in the subcapsular
region, consistent with
liquefactive necrosis from
previous splenic infarcts.
Multifocal infarcts may be due
to embolic processes.
Differential Diagnoses: Spleen
Splenic Hematoma/Laceration
Splenic Hematoma/Laceration
(Left) Longitudinal US shows
cystic change ſt in a splenic
hematoma. Note that part of
the hematoma remains
echogenic, representing acute
component. (Right)
Longitudinal US shows
liquefactive necrosis with
cystic change ſt in the
subacute stage of a splenic
laceration. The history of
trauma is important to make
the diagnosis of laceration.
Hamartoma
Lymphangioma
(Left) Longitudinal US shows a
calcified splenic hamartoma
; it is well defined and
echogenic. The echogenicity is
higher than that seen in a solid
tumor, e.g., hemangioma, and
is suggestive of a calcified
lesion. (Right) Longitudinal US
of the spleen shows a splenic
lymphangioma ſt. Note its
multiloculated, thin-walled,
cystic appearance and the
normal surrounding
parenchyma.
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