CT patterns of splenic infarction: a clinical and experimental study.

Abstract

The computed tomographic (CT) appearance of splenic infarction has classically been described as peripheral, wedge-shaped, and low in density. Two investigations were designed to determine the appearance of splenic infarcts: (a) a clinical study of 12 patients and (b) a canine experimental model. In the clinical study, two previously undescribed patterns of splenic infarction were found. The classic peripheral, wedge-shaped defects were seen in four patients; multiple, heterogeneous lesions were seen in five; and massive hypodense lesions were noted in three. In three of the nine patients who had both precontrast and postcontrast CT scans, the unenhanced images alone would not have permitted the diagnosis. Contrast enhancement markedly improved infarct visualization in the remaining six. The experimental study of splenic infarction in dogs indicated that CT images can accurately depict the various phases of an infarct as it evolves through stages of congestion, hemorrhage, inflammation, organization, and fibrosis. In addition, a new contrast material--liposome-encapsulated diatrizoate--was used in one of the dogs and was found to produce greater and more sustained differences between normal and abnormal tissue than did conventional contrast material.

CT of acquired abnormalities of the spleen.

“…16) Frequently, it is caused by arterial emboli (usually from the heart), or from involvement of the local vascular I--. initially, a higher attenuation or a mottled appearance may be present, followed by a progressive decrease in attenuation with age [6]. The shape may vary from spherical or geographic areas of altered texture (Fig.…”

Clinical spectrum of splenic infarction – a South Indian perspective

“…Ultrasonogram is useful when splenic parenchyma is not obscured by bowel gas or morbid obesity. Computerised tomography is the diagnostic modality of choice [17]. Other methods include gadolinium enhanced MRI, splenic scintigraphy with radio-labelled colloids, and RBC scans.…”

Splenic Infarction in Malaria

“…When splenic infarction occurs secondary to septicemboli in infective endocarditis, upto 90% of patients have no localizing findings. The radiographic characteristics of splenic infarction with either ultrasonography [6] or computedtomography (CT) are well defined, though CT has emerged as the preferred imaging modality for making the diagnosis [7]. When the infarcts are small, the prognosis is usually favourable.The wedge-shaped infarct has its apex towards the hilum and its base beneath the capsule.…”