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Ultrasonography The Spleen VCA 341 Dr. LeeAnn Pack

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Presentation on theme: "Ultrasonography The Spleen VCA 341 Dr. LeeAnn Pack"— Presentation transcript:

1 Ultrasonography The Spleen VCA 341 Dr. LeeAnn Pack

2 Indications Splenomegaly Palpable splenic mass
Cranial abdominal organomegaly Lethargy, collapse Anemia, abnormal RBC’s

3 Ultrasound Technique Left side of body Head of spleen
Under border of rib cage on left Body & tail of spleen Along left body wall Ventral or lateral to left kidney Scan sagittal & transverse

4 Anatomy Size of normal spleen variable Parenchyma Echogenicity
Assessed subjectively Enlarged spleen may cross midline or extend caudally to the bladder Parenchyma Homogenous, finely textured Echogenicity Dog: Spleen > liver > kidney Cat: Spleen = liver > kidney

5 Normal Spleen

6 Anatomy Capsule Splenic veins Hilus Smooth, regular, VERY echogenic
Only other structure normally visualized Poorly visualized except near hilus “Whale tail” Enlargement subjective Hilus Check for lymphadenopathy

7 Splenic Hilus

8 Pathology Diffuse splenomegaly Congestion Torsion
Inflammation/septicemia Neoplasia Lymphosarcoma Mast cell tumor Phenothiazine tranquilizers & barbiturate anaesthetics Extramedullary hematopoesis

9 Pathology Focal or multifocal splenic lesions Hematoma Infarcts Cysts
Abscess Nodular hyperplasia Neoplasia Hemangioma Hemangiosarcoma

10 Diffuse Splenomegaly Diffuse increase in echogenicity uncommon
Neoplastic (mast cell or lymphosarcoma) Diffuse decrease in echogenicity more common Congestion Extra-medullary hematopoesis Lymphosarcoma Inflammation/ septicemia Torsion Normal echogenicity can occur with lymphosarcoma & mast cell tumor Break this slide up

11 Non Homogenous

12 Focal/Multifocal Lesions
More common than diffuse Anechoic Cysts Hematoma/neoplasia Hypoechoic Neoplasia Abscess Acute infarct Nodular hyperplasia

13 Focal/Multifocal Lesions
Hyperechoic Neoplasia Abscess Chronic infarct Nodular hyperplasia Mixed echogenicity Hematoma

14 Splenic Mass

15 Splenic Mass

16 Splenic Infarct

17 Torsion Definitive diagnosis by ultrasound Characteristic appearance
Severe, diffuse splenomegaly Hypoechoic Coarse & “lace-like” Venous blood flow absent on Doppler +/- hyperechoic venous thrombi Lymphosarcoma can appear similar Normal blood flow

18 Torsion

19 Neoplasia Lymphosarcoma Hematoma, hemangioma, hemangiosarcoma
Diffuse or focal/multifocal Hypoechoic or hyperechoic Can appear normal Hematoma, hemangioma, hemangiosarcoma Unable to differentiate Focal Hypoechoic, hyperechoic or mixed

20 Lymphosarcoma

21 Hemangiosarcoma

22 Neoplasia Other neoplasms
Mast cell tumor, leiomyoma, etc. Presence of peritoneal effusion not a good indication of malignancy Metastasis Lungs, liver, lymph nodes (splenic, hepatic, gastric)

23 Echogenic Focal Lesions
Focal fat deposits Especially cats Surround hepatic veins (myelolipomas) Fibrosis & calcification Secondary to hematoma, chronic infarcts or granulomas (histoplasmosis) Primary or metastatic neoplasia

24 Definitive Diagnosis Ultrasonic appearance of most splenic diseases non-specific Consider history, signalment, clinical signs Fine needle aspirate useful Biopsy generally not performed Does this apply to neoplasms? Focal lesions? What exactly?

25 Rupture Free fluid within the abdomen Most likely a tumor
Often echoic (due to  blood cells) May be anechoic Most likely a tumor Cannot rule out hematoma

26 Thrombosis

27 Splenic Thrombus

28 Myelolipoma

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