Differentiation of Focal Splenic Lesions in Ultrasound Examination
The assessment of focal splenic lesions in ultrasound diagnostics relies on a systematic approach by dividing lesions based on structure (cystic and solid) and quantity (solitary and multiple). This structure of the differential diagnosis is reflected in specialized literature (ExpertDDx: Abdomen and Pelvis, 2023).
Principles of Differential Diagnosis
Sources highlight distinct approaches to multiple splenic lesions, differential diagnosis of cystic and solid lesions, as well as solitary splenic lesions (Kamaya A, et al. Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions; Warshauer DM, et al. Solitary splenic lesions, Semin Ultrasound CT MR, 2006).
Multiple Lesions and Diffuse Changes
For conditions with diffuse increased density/echogenicity of the spleen, a range of causes are included in the differential diagnosis (ExpertDDx: Abdomen and Pelvis, 2023):
| Category | Causes |
|---|---|
| Common | Secondary hemochromatosis; splenic infarction; sickle cell anemia; siderotic nodules of the spleen |
| Less common | [clarify] |
The Role of Additional Imaging Methods
Specific ultrasound criteria for differentiating individual focal splenic lesions are not provided in the presented fragments [clarify]. When ultrasound is insufficient to determine the boundaries and point of origin of the lesion, patients often undergo CT or MRI of the abdomen for better delineation of structures (Textbook of Diagnostic Sonography, 2023).
Frequently asked questions
How are focal splenic lesions classified in differential diagnosis?
They are divided into cystic and solid, as well as solitary and multiple (Kamaya A, et al.; Warshauer DM, et al., Semin Ultrasound CT MR, 2006).
What causes are included in the differential diagnosis for multiple/diffuse splenic changes?
Among common causes are secondary hemochromatosis, splenic infarction, sickle cell anemia, and siderotic nodules of the spleen (ExpertDDx: Abdomen and Pelvis, 2023).
When should ultrasound be supplemented with other imaging methods?
When it is not possible to clearly determine the boundaries and point of origin of the lesion, CT or MRI of the abdomen is performed for better delineation of structures (Textbook of Diagnostic Sonography, 2023).
Are there specific ultrasound criteria for individual splenic lesions in the fragments?
Specific ultrasound criteria for differentiating individual focal splenic lesions are not provided in the presented fragments [clarify].