ULTRASOUND OF THE SPLEEN - Normal
|Intercostal scan plane||Normal Spleen
|The size of the spleen can be extremely variable ranging from 7cm- 14cm.
Accesory spleens or splenunculi are common.
(singular = splenunculus)
Ultrasound of the Spleen - Protocol
To assess the size, shape, texture and vascularity of the spleen.
The spleen has a homogeneous, "inverted comma" appearance.
When it becomes enlarged it loses this shape and, as it expands, it becomes very rounded and sometimes appears as an egg shape extending beyond the Left kidney.
Normal Spleen Size
<13 cm superior to inferior axis
6-7cm in the medial to lateral axis
5 to 6cm in the anterior to posterior plane. Average volume is approximately 350mls
Ref : SONOGRAPHY Introduction to Normal Structure and Function Second Edition Reva Arnez Curry and Betty Bates Tempkin Saunders
Ref: Ultrasound: The Requisites, CHAPTER 8, 209-219
The spleen is considered enlarged if it covers the entire left kidney.
Start with the pt supine.
Angle the probe between the ribs intercostally from a posterolateral approach.
Overlying bowel gas, overlying lung base or rib shadows can cause problems. Slowly roll the patient, to improve visualistaion.
Try inspiration,expiration,distended abdomen,erect
Rarely the left lobe of the liver (if enlarged) may be used as a window to assess to superoanterior portion of the spleen.
At least one image of the spleen with a measurement from tip to tail.