Main description:

Only a few years ago, most treatises on sonography covered all the diagnostic applications of ultrasound, de- scribing organs from the brain down to the placenta. Dr. Bruneton and his associates must be thanked for pre- senting this book devoted to the spleen. It probably offers the most complete presentation of details and the richest images available in its field. This book will thus become the ultimate reference in most libraries of books on son- ography. March 1988 F. Weill The authors wish to thank Christine Rostagni, Fran~ise Fein, and Bernard Fontaine for their assistance in the preparation of this book. Contents 1 Sonographic Anatomy of the Normal Spleen, Normal Anatomic Variants, and Pitfalls B. Senecail ...1 1. 1 Anatomy of the Spleen...1 1. 1. 1 Morphology and Structure ...1 1. 1. 2 Location and Relations of the Spleen...3 1. 1. 3 Average Dimensions of the Cadaver Spleen ...5 1. 1. 4 Congenital Anomalies and Normal Variants...5 1. 1. 4. 1 Fissured Spleen...5 1. 1. 4. 2 Lobulated Spleen...5 1. 1. 4. 3 Spleen with Two Hili...5 1. 1. 4. 4 Wandering or Ectopic Spleen ...6 1. 1. 4. 5 Numeric Anomalies ...6 Ultrasonography of the Spleen ...1. 2 6 1. 2. 1 Equipment ...6 1. 2.
2 Patient Examination ...7 1. 2. 3 Scanning Technique ...7 1. 3 Sonographic Features of the Normal Spleen...7 1. 3. 1 Splenic Contour ...7 1. 3. 2 Echo Pattern of the Splenic Parenchyma...

Contents:

1 Sonographic Anatomy of the Normal Spleen, Normal Anatomic Variants, and Pitfalls.- 1.1 Anatomy of the Spleen.- 1.1.1 Morphology and Structure.- 1.1.2 Location and Relations of the Spleen.- 1.1.3 Average Dimensions of the Cadaver Spleen.- 1.1.4 Congenital Anomalies and Normal Variants.- 1.1.4.1 Fissured Spleen.- 1.1.4.2 Lobulated Spleen.- 1.1.4.3 Spleen with Two Hili.- 1.1.4.4 Wandering or Ectopic Spleen.- 1.1.4.5 Numeric Anomalies.- 1.2 Ultrasonography of the Spleen.- 1.2.1 Equipment.- 1.2.2 Patient Examination.- 1.2.3 Scanning Technique.- 1.3 Sonographic Features of the Normal Spleen..- 1.3.1 Splenic Contour.- 1.3.2 Echo Pattern of the Splenic Parenchyma.- 1.3.3 Analysis of Splenic Sonograms.- 1.3.3.1 Scans Parallel to the Long Axis.- 1.3.3.2 Scans Perpendicular to the Long Axis.- 1.3.4 Sonographic Splenometry.- 1.3.5 Sonographic Pitfalls.- 1.3.5.1 Splenic Ectopia.- 1.3.5.2 The Lobulated Spleen.- 1.3.5.3 Accessory Spleens.- 1.4 Conclusion.- 1.4.1 Quantitative Sonographic Criteria.- 1.4.2 Qualitative Sonographic Criteria.- 1.5 References.- 2 Congenital Anomalies of the Spleen.- 2.1 Situs Inversus.- 2.1.1 Uncomplicated Situs Inversus.- 2.1.1.1 Total Situs Inversus.- 2.1.1.2 Partial Situs Inversus.- 2.1.2 Complicated Situs Inversus.- 2.2 Asplenia.- 2.2.1 Bronchopulmonary Abnormalities.- 2.2.2 Liver.- 2.2.3 Gallbladder.- 2.2.4 Stomach, Pancreas, Duodenum.- 2.2.5 Intestinal Anomalies.- 2.2.6 Genitourinary Anomalies.- 2.2.7 Endocrine Glands.- 2.2.8 Musculoskeletal Anomalies.- 2.2.9 Biologic Anomalies.- 2.2.10 Cardiovascular Anomalies.- 2.2.10.1 Systemic Veins.- 2.2.10.2 Pulmonary Veins.- 2.2.10.3 Great Vessels.- 2.2.10.4 Heart.- 2.3 Polysplenia.- 2.3.1 Gross Anatomy.- 2.3.2 Associated Noncardiovascular Malformations.- 2.3.3 Associated Cardiovascular Anomalies.- 2.3.3.1 Venae Cavae.- 2.3.3.2 Pulmonary Veins.- 2.3.3.3 Great Vessels.- 2.3.3.4 Heart.- 2.4 Wandering Spleen.- 2.4.1 Causative Factors.- 2.4.1.1 Congenital Causes.- 2.4.1.2 Acquired Causes.- 2.4.2 Clinical Manifestations.- 2.4.3 Imaging Studies.- 2.4.3.1 Plain Abdominal Films.- 2.4.3.2 Ultrasonography.- 2.4.3.3 Scintigraphy.- 2.4.3.4 Computed Tomography.- 2.4.3.5 Other Radiologic Techniques.- 2.4.4 Treatment of Uncomplicated Wandering Spleen.- 2.4.5 Torsion of the Splenic Pedicle.- 2.4.5.1 Subacute and Chronic Torsion.- 2.4.5.2 Acute Torsion.- 2.4.5.3 Causative Factors.- 2.4.5.4 Clinical Manifestations.- 2.4.5.5 Radiologic Signs.- 2.4.5.6 Treatment.- 2.5 Splenogonadal Fusion.- 2.5.1 Anatomic Classification.- 2.5.1.1 Continuous Splenogonadal Fusion.- 2.5.1.2 Discontinuous Splenogonadal Fusion.- 2.5.2 Associated Anomalies.- 2.5.3 Pathogenesis.- 2.5.4 Circumstances of Detection.- 2.5.5 Differential Diagnosis.- 2.5.6 Imaging Studies.- 2.5.6.1 Radionuclide Scanning.- 2.5.6.2 Arteriography.- 2.5.6.3 Ultrasonography.- 2.5.6.4 Treatment.- 2.6 Conclusion.- 2.7 References.- 3 Splenic Trauma.- 3.1 Causes and Clinical Manifestations.- 3.2 Ultrasonography of the Traumatized Spleen.- 3.2.1 Technique.- 3.2.2 Sonographic Features of Splenic Lesions.- 3.2.2.1 Free Intraperitoneal Fluid.- 3.2.2.2 Intrasplenic Lesions.- 3.2.3 Management of Splenic Trauma.- 3.2.3.1 Conservative Surgery.- 3.2.3.2 Indications for Splenic Ultrasonography.- 3.2.4 Patterns of Lesion Evolution.- 3.2.5 Reliability of Splenic Sonography and Differential Diagnosis.- 3.2.5.1 Value of Ultrasonography.- 3.2.5.2 Differential Diagnosis.- 3.3 Other Diagnostic Techniques.- 3.3.1 Peritoneal Lavage.- 3.3.2 Liver-Spleen Scintigraphy.- 3.3.3 Computed Tomography (CT).- 3.3.4 Angiography.- 3.4 Conclusion.- 3.5 References.- 4 Splenic Tumors.- 4.1 Malignant Tumors.- 4.1.1 Lymphomas.- 4.1.1.1 Non-Hodgkin Lymphoma.- 4.1.1.2 Hodgkin'sease.- 4.1.2 Leukoses.- 4.1.3 Sarcomas.- 4.1.3.1 Hemangiosarcomas.- 4.1.3.2 Other Sarcomas.- 4.1.4 Secondary Malignant Tumors.- 4.2 Benign Tumors.- 4.2.1 Cysts.- 4.2.1.1 Epithelial Cysts.- 4.2.1.2 Endothelial Cysts.- 4.2.1.3 False Cysts.- 4.2.1.4 Enteroid Cysts.- 4.2.2 Benign Noncystic Tumors.- 4.2.2.1 Hamartoma.- 4.2.2.2 Hemangioma.- 4.2.2.3 Lymphangioma.- 4.2.2.4 Other Benign Tumors.- 4.3 Conclusion.- 4.4 References.- 5 Splenic Abscess and Infarction.- 5.1 Pathogenesis.- 5.1.1 Hematogenous Spread.- 5.1.2 Direct Extension of a Local Infection.- 5.1.3 Bacteriology.- 5.2 Clinical Presentation.- 5.3 Imaging Studies.- 5.3.1 Chest Radiographs.- 5.3.2 Ultrasonography and Computed Tomography..- 5.3.2.1 Ultrasonography.- 5.3.2.2 Computed Tomography (CT).- 5.4 Differential Diagnosis.- 5.5 Relation Between Splenic Abscess and Infarction.- 5.6 Conclusion.- 5.7 References.- 6 Splenic Involvement in Parasitoses.- 6.1 Parasitic Infections of the Spleen.- 6.1.1 Echinococcosis (Hydatid Disease).- 61.1.1 Unilocular Hydatid Disease.- 6.1.1.2 Alveolar Hydatid Disease.- 6.1.2 Histoplasmosis.- 6.1.2.1 General Features.- 6.1.2.2 Sonographic Features.- 6.1.3 Amebiasis.- 6.1.3.1 General Features.- 6.1.3.2 Sonographic Features.- 6.2 Splenic Lesions Secondary to Hepatic Parasitoses.- 6.2.1 Schistosomiasis.- 6.2.1.1 General Features.- 6.2.1.2 Sonographic Features.- 6.3 Nonspecific Homogeneous Splenomegaly.- 6.3.1 Malaria.- 6.3.1.1 General Features.- 6.3.1.2 Sonographic Features.- 6.3.2 Leishmaniasis (Kala Azar).- 6.3.2.1 General Features.- 6.3.2.2 Sonographic Features.- 6.3.3 Toxoplasmosis.- 6.3.3.1 Congenital Toxoplasmosis.- 6.3.3.2 Acquired Toxoplasmosis.- 6.3.4 Trypanosomiasis.- 6.3.4.1 General Features.- 6.3.4.2 Sonographic Features.- 6.3.5 Idiopathic Splenomegaly.- 6.4 Conclusion.- 6.5 References.- 7 Subject Index.