脾脏超声检查

• Nodules are common and non-specific finding with variable echogenicity 常见结节、没有特意性发现、回声差异较大
• DDX:
• nodular hyperplasia 结节性增生 • Extramedullary hematopoesis 髓外造血 • Hematoma 血肿 • Infection 感染 • Infiltrative neoplasia 肿瘤浸润 • Metastatic disease 转移性疾病
• Triangular on cross section 截面图是三角形 • Elongated and tongue shaped 长、舌状 • Hyperechoic to liver/left kidney cortex
比肝脏/左肾皮质回声高
• Superficial along left body wall 浅表、沿左侧体壁
• Extramedullary hemtopoesis 髓外造血
• Infectious diseases 感染
• Splenic torsion 脾脏扭转
• Malignant infiltration (lymphoma, Mast cell tumors) 恶性浸润（淋巴瘤，肥大细胞瘤）
• Diffuse change in echogenicity 弥散性病变
• Well-differentiated adipose tissue 分化良好的脂肪组织
• Subjective evaluation 主观评估
• Extends more caudally and in contact with the urinary bladder 扩展到下腹部与膀胱相连
• Depends on gastric contents and size 要看胃内容物和胃的大小
• Smooth outline with echogenic capsule 边缘光滑，有回声
• Homogeneous fine echotexture (compared to liver) （与肝脏比）回声均匀
• Head attached to stomach 头与胃接近 (gastrosplenic ligament) 脾胃韧带
• Body and tail variable in position 脾脏体和脾脏头位置变化
• Along left body wall 沿左侧体壁 • Courses transversely across abdomen 横穿过腹部
• Hypoechoic 低回声 • Hyperechoic 高回声 • mixed echogenicity 混合回声
• Focal abnormalities 局部病变
• Multifocal abnormalities 多处异常
HYPO 低回声
acute congestion 急性充血
↑ reticuloendothelial activity网状内皮活力
acute splenitis 急性脾脏炎症
HYPER 高回声
chronic congestion 慢性充血
chronic myeloproliferative disease慢性骨髓增生疾病
chronic inflammation 慢性感染
HYPOECHOIC 低回声
Diffuse infiltrative diseases
• Nonsinusal spleen>> less blood storage capacity 无脾窦脾脏>>储藏血液能力很弱
• Splenomegaly more likely to be disease (folding of spleen) 脾脏肿大基本上都是病态（脾脏扭转）
Accessory spleen 脾脏附属 Incidental finding 偶然发现 Single or multiple islands of normal splenic parenchyma
Regeneration
HSA
• Strongly hyperechoic nodules 强回声结节
• Peripheral or adjacent to blood vessels 血管外周或附近
在正常脾脏里的单个或多个岛 Frequently at splenic
hilus 经常在脾门区
• Strongly hyperechoic nodules 超强回声的结节
• Peripheral or adjacent to blood vessels 血管外周或附近
• Incidental benign finding 偶然良性发现
弥漫浸润性疾病
non –neoplastic: extramedullary haematopoiesis, amyloidosis
非肿瘤性：髓外造血，淀粉样变
neoplastic infiltration (lymphoma, leukemia, histiocytic sarcoma, mast cell tumor) 肿瘤浸润（淋巴瘤，白血病，组织细胞肉瘤，肥大细 胞瘤）
• Location 位置
• Size
大小
• Shape 形态
• Margins 边缘
பைடு நூலகம்
• Echogenicity 回声强度
• echostructure/ architecture of
the parenchyma 实质的回声
• Vessels 血管
• Head of spleen in left intercostal space 脾脏头在左肋骨里
• Extends in the right abdomen 扩展到右侧腹部
• Rounded margins 边缘钝园
• Sedation or anaesthesia (phenothiazine, barbiturate) 镇静或麻醉（吩噻嗪、巴比妥盐）
• Breed associated (Shepard) 与品种有关（牧羊犬）