← All decks
Radiology
Fetal Spleen
Built from Obstetric Imaging
What’s inside
12 sections · 118 slides
Overview
- What you will learn here
The organ itself
What the spleen does before birth and how it is built
- Why anyone scans the fetal spleen
- The spleen makes blood before birth
- After birth the job changes
- How the spleen forms
- Where it starts and what holds it
- Lobules and the coffee bean
- Splenic artery arising from the coeliac trunk
- Follow the artery to find the organ
Finding it on ultrasound
When it appears, where to look, and why absence is hard to prove
- The spleen shows up late
- The view that shows the spleen
- Finding the fetal spleen, step by step
- Why the spleen hides
Normal size
Why reference charts exist and what they measure
- Why normal values were built
- What actually gets measured
- How to read the size chart
- Reference Values for Normal Splenic Measurements Obtained by Ultrasound (Fetal Abdominal Cross Sections) by Gestational Age
- Published size chart as printed in the source
- What the size chart teaches
Doppler of the splenic vessels
Flow in the splenic artery and vein, and what it predicts
- What Doppler adds
- Two numbers Doppler gives you
- Splenic vessels on colour and spectral Doppler
- Locating the splenic artery
- Reading the flow trace
- The study that built the reference ranges
- Reference curves for splenic artery velocity and pulsatility
- Speed rises through pregnancy
- Pulsatility peaks then falls
- Splenic flow moves with brain and cord flow
- Where that becomes useful
- A window on gut and liver circulation
- The splenic vein should be quiet
- A pulsating splenic vein flags inflammation
- Confirmed on histology too
- Two more uses of the splenic vessels
What can go wrong
Position, size and malformation — the three kinds of finding
- Three kinds of abnormal finding
- Accessory spleens
- Why accessory spleens matter
Congenital splenic cysts
Usually a chance finding with a good outlook
- Two kinds of splenic cyst
- What separates the two types
- Where each type comes from
- How common are they
- Why a cyst forms in the spleen
- When and how they are found
- The classic ultrasound look
- When the cyst looks less simple
- What MRI shows
- What else makes a cyst here — organs nearby
- What else makes a cyst here — gland and gut
- What else makes a cyst here — the rest
- Treatment before birth
- Treatment after birth
- When something must be done
- What the referring clinician needs to know
Cardiosplenic syndromes
When left and right stop being different
- The body is not symmetrical inside
- Complete versus partial sidedness defects
- Normal, mirror-image and ambiguous organ arrangement
- Reading the three-panel comparison
- Situs ambiguus splits two ways
- Isomerism in one sentence
- Polysplenia, or left isomerism
- The rest of the left isomerism picture
- Normal chest and abdominal organs compared with left isomerism
- What changes in the left isomerism panel
- Cross section of the upper abdomen in polysplenia
- The cross-section view you actually scan
- Asplenia, or right isomerism
- Why right isomerism is the worse one
- Left and right isomerism side by side
- 1.44
- Reading the incidence figure
- Why the body loses its sidedness
- How the diagnosis usually starts
- The most reliable ultrasound clue
- The double-vessel sign explained
- Double-vessel sign behind the heart
- The long view of the two vessels
- The cross-cut view of the two vessels
- Other ultrasound signs to hunt for
- Why MRI earns a place here
- What MRI keeps finding
- Telling the two syndromes apart is hard
- Care before birth
- What happens after birth
- What the referring clinician needs to know
Splenogonadal fusion-limb defect syndrome
A rare link between the spleen, the gonad and the limbs
- Spleen stuck to the gonad
- How rare is rare
- Why the spleen ends up down there
- What you might see on the scan
- Classification and outlook
Big spleen, small spleen
Splenomegaly as a signal, and the rare hypoplastic spleen
- Too big and too small
- How common is either
- Why anaemia enlarges the spleen
- Splenomegaly as the classic anaemia sign
- Spleen size as a screening idea
- Infection makes it swell too
- The spleen and membrane infection
- Genetic and storage causes
- Causes of a large fetal spleen
- The rare small spleen
- Why a big spleen is easy to miss
- Indirect signs of an enlarged spleen
- Let colour Doppler settle it
- Working out the cause
- Treating a big spleen
- What the referring clinician needs to know
Take it away
The points worth carrying into the scan room
- Key points
- Key points, continued
- Three habits worth keeping
References
The source list this material is drawn from
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition