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Spleen ultrasound
Last reviewed: 04.07.2025
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Ultrasound technique of the spleen
Perform the scan with the patient supine or in a prone position. Multiple slices are required.
Scan from below the costal arch, tilting the transducer toward the diaphragm, then along the ninth intercostal space and down. Repeat the examination through all lower intervals, first with the patient in the supine position, then in the lateral position, in the inclined position on the right side (30°).
Then perform longitudinal sections from the anterior to the posterior axillary line, as well as transverse sections in the upper abdomen. Also scan the liver, especially if the spleen is enlarged.
Methodology for performing ultrasound examination of the spleen
When the spleen is of normal size, it is difficult to obtain a complete image in one section. The splenic hilum is the starting point for the correct identification of the spleen. The splenic hilum is defined as the entry point of the splenic vessels.
Ultrasound signs of a normal spleen
It is very important to identify:
- Left dome of the diaphragm.
- Gate of the spleen.
- Splenic veins and the relationship of the spleen to the pancreas.
- Left kidney (renosplenic relationship).
- Left edge of the liver.
- Pancreas.
When the spleen is of normal size, it is difficult to obtain a complete image in one section. The splenic hilum is the starting point for the correct identification of the spleen. The splenic hilum is defined as the entry point of the splenic vessels.
It is important to be able to identify the left dome of the diaphragm and the superior edge of the spleen.
Echostructure
The spleen usually has a homogeneous echotexture. It is slightly less echogenic than the liver.
Ultrasound signs of spleen pathology
The most common mistakes in ultrasound examination of the spleen
The following structures may be mistaken for splenic neoplasms:
- Formations in the kidney.
- Tail of the pancreas.
- Adrenal tumors.
- Stomach.