Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Case 50 Simulated active bleeding
- Case 51 Pseudopneumoperitoneum
- Case 52 Intra-abdominal focal fat infarction: epiploic appendagitis and omental infarction
- Case 53 False-negative and False-positive FAST
- Liver and biliary
- Spleen
- Case 56 Splenic clefts
- Case 57 Inhomogeneous splenic enhancement
- Case 58 Pseudosubcapsular splenic hematoma
- Pancreas
- Bowel
- Kidney and ureter
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 57 - Inhomogeneous splenic enhancement
from Spleen
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Case 50 Simulated active bleeding
- Case 51 Pseudopneumoperitoneum
- Case 52 Intra-abdominal focal fat infarction: epiploic appendagitis and omental infarction
- Case 53 False-negative and False-positive FAST
- Liver and biliary
- Spleen
- Case 56 Splenic clefts
- Case 57 Inhomogeneous splenic enhancement
- Case 58 Pseudosubcapsular splenic hematoma
- Pancreas
- Bowel
- Kidney and ureter
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
The spleen is primarily composed of red and white pulp, separated by a marginal zone of reticular cells (Figure 57.1) [1]. The red pulp consists of large numbers of blood-filled sinuses and sinusoids and is responsible for splenic filtration – filtering foreign material and damaged red blood cells. The white pulp is composed of aggregates of lymphoid tissue responsible for the immunologic function of the spleen [1]. The enhancement dynamics of the spleen are largely attributed to the different blood flow rates through these two tissue structures [2]. If the spleen is imaged in an early arterial phase, the parenchyma can appear heterogeneous as patches of unenhanced white pulp contrast with normally enhanced red pulp.
Three principal patterns of splenic enhancement have been described – archiform, focal, and diffuse. Archiform patterns typically appear as alternating bands of high and low attenuation, a ring-like pattern, or a zebra-stripe pattern (Figure 57.2) [3]. Focal lesions appear as a single area of low attenuation (Figure 57.3). Diffuse enhancement appears as a mottled pattern throughout the splenic parenchyma.
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- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 189 - 191Publisher: Cambridge University PressPrint publication year: 2013