The Spleen (Davies Board Review)

You are performing an abdominal ultrasound scan and detect a hypoechoic, wedge-shaped lesion within the spleen. This is the typical appearance of what?

Splenic infarction

What structure will you detect at the splenic hilum?

Splenic vein

An average sized male pt has been referred for ultrasound evaluation of splenomegaly. What transducer would provide the highest resolution images of the spleen?

5.0 MHz curved linear array

During routine sonographic evaluation of the spleen, you detect a small, rounded mass at the splenic hilum that is homogeneous and isoechoic with the spleen. You have most likely detected what?

Accessory spleen

You are performing an ultrasound study on a pt with a history of recent blunt left sided trauma in a motor vehicle accident. What is NOT associated with this history?

Calcified splenic cyst

During abdominal sonography of a pt with portal hypertension and splenomegaly, you detect a calcified ring at the splenic hilum. What should you do?

Evaluate the area with color Doppler

What would be the most helpful in improving diagnostic confidence in a case with a hypoechoic, wedge-shaped lesion within the spleen an entity of splenic infarction?

Evaluate the lesion with color Doppler

In a case of portal hypertension where you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum, considering the ultrasound findings, what additional information should you provide?

Evaluate the liver and portal vein

Which term can be used to describe the normal sonographic appearance of the splenic parenchyma?

Homogeneous with mid-to-low level echogenicity

What is NOT a feature you would detect in a splenic cyst?

Increased attenuation

You have been asked to evaluate the tail of the pancreas. What is the relationship of the pancreatic tail to the spleen?

Inferomedial

You are examining the spleen during a routine sonogram. What view provides the best long axis image of the spleen?

Intercostal coronal view with pt supine

What is a pitfall you might encounter in ultrasound scanning of the spleen?

Intercostal scanning may produce rib shadows obscuring the splenic parenchyma, in hepatomegaly the left lobe of the liver may be mistaken for the spleen, a mass in the tail of the pancreas may be confused with a splenic mass, an accessory spleen may be confused with an enlarged lymph node

You are performing an abdominal ultrasound and are having difficulty identifying the spleen. What structures are in contact with the spleen?

Left hemidiaphragm, stomach, pancreas and splenic flexure of the colon

You are performing an ultrasound study on a pt with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents what?

Metastasis

You are imaging the spleen of a 27-year-old male with AIDS. What is the most common finding in the spleen in pts with AIDS?

Moderate splenomegaly

You are performing an abdominal ultrasound on a pt with histoplasmosis. What findings of the spleen are commonly seen with this condition?

Multiple focal, bright echogenic granulomatous lesions throughout the spleen

During splenic sonography, you detect moderate splenomegaly and dilated, tortuous vessels at the splenic hilum. What condition do you suspect?

Portal hypertension

You are scanning a pt with moderate splenomegaly. What is a cause of mild to moderate splenomegaly?

Portal hypertension, infection and AIDS

The splenic vein drains into what vein?

Portal vein

What is NOT true regarding the spleen?

The spleen is NOT a retroperitoneal structure