Imaging

Splenic Infarction

Preliminary Diagnosis: Splenic Infarction

I. What imaging technique is first-line for this diagnosis?

CT scan of the abdomen and pelvis with IV contrast.

II. Describe the advantages and disadvantages of this technique for diagnosing splenic infarction.

Advantages

  • Most sensitive and specific imaging modality in detecting and characterizing a splenic infarct.

  • Highly specific in characterizing the primary lesion and detecting any secondary complications, i.e., abscess, hemorrhage, ruptured spleen, and pseudocyst formation.

  • May guide treatment and therapy.

  • Characterizes the surrounding soft tissues, osseous structures, and vasculature.

Disadvantages

  • Exposes patients to ionizing radiation.

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients.

  • May be contraindicated in patients with contrast allergy or patients with renal failure.

IV. What alternative imaging techniques are available?

Gray scale, Color Doppler, and spectrum waveform analysis sonographic evaluation of the spleen and splenic vasculature.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing splenic infarction.

Advantages

  • Does not expose patients to ionizing radiation.

  • Highly portable.

  • Moderately sensitive and moderately specific in characterizing the spleen and splenic vasculature.

Disadvantages

  • Sonographic imaging is highly operator dependent.

VI. What are the contraindications for the alternative imaging techniques?

No specific contraindications to ultrasound exist.

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