Ultrasonography of the Spleen

ISBN-13: 9783642732010 / Angielski / Miękka / 2011 / 89 str.

Jean-Noel Bruneton; Michel Benozio; Michel Blery

Opis

This is the first book devoted solely to ultrasonography of the spleen. Its particular value to the reader can be explained by several factors: firstly, ultrasonography is the first examination to be performed after physical examination; secondly, splenic ultrasound can be performed rapidly in emergency settings and in an infectious context; thirdly, it is a necessary procedure for epidemiological work in regions such as Africa, where parasitoses are endemic; and, finally, it is useful for the work-up of neoplasms. The book is divided into chapters covering normal sonoanatomy of the spleen, congenital malformations, splenic trauma, tumors, infections, and involvement in parasitoses. In all chapters, the advantages of ultrasound examination are compared with those of other imaging techniques, and the role of ultrasonography in strategies for splenic exploration is defined as a function of the clinical setting. The book thereby allows optimal utilization of ultrasonography based on a thorough understanding of splenic pathology.

Spis treści

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.