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Ultrasonography of the pediatric spleen: a pictorial essay

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Abstract

In infants and children, the spleen is involved in many pathological processes, whether those processes are isolated or related to systemic diseases. Pathology of the pediatric spleen includes congenital anomalies, splenomegaly, trauma, focal lesions, infarction, and tumors. Ultrasonography (US) is a widely available, fast, noninvasive imaging technique to assess the size, shape, and position of the spleen, as well as to define splenic echotexture. US is capable of screening for splenic disorders without the risk of ionizing radiation; it is the initial imaging examination performed to evaluate suspected splenic pathology, providing clinicians with helpful decisional support. US plays an important role in the detection of even very small amounts of hemoperitoneum, a herald of significant abdominal organ injury, in pediatric blunt abdominal trauma. Moreover, contrast-enhanced US may allow early detection of splenic injuries, ideally minimizing children’s risk from radiation exposure. This pictorial essay illustrates the normal ultrasound appearance of the pediatric spleen and the sonographic findings which may guide clinicians to a correct diagnosis of pathologic conditions.

Sommario

In età pediatrica la milza è coinvolta in molti processi patologici, che possono manifestarsi come entità isolate o possono essere secondarie a malattie sistemiche. I quadri patologici splenici includono anomalie congenite, splenomegalia, trauma, lesioni focali, infarti e tumori. L’ecografia è una metodica largamente disponibile, veloce e non invasiva che permette di determinare le dimensioni, la posizione e la morfologia della milza e di caratterizzarne inoltre l’ecotessitura parenchimale. L’esame ecografico permette di identificare precocemente le alterazioni spleniche senza il rischio di radiazioni ionizzanti e viene per questo motivo utilizzato come metodica di imaging iniziale per valutare quadri sospetti di patologia splenica fornendo ai clinici un utile supporto decisionale. Nei traumi addominali chiusi, l’ecografia svolge un ruolo importante nell’identificare quantità persino esigue di emoperitoneo, reperto associato a significative lesioni degli organi addominali. Inoltre, l’utilizzo dell’ecografia con mezzo di contrasto potrebbe permettere di identificare precocemente lesioni traumatiche della milza, e ridurre, idealmente, al minimo le radiazioni nei pazienti pediatrici. Questo pictorial essay illustra il normale aspetto ecografico della milza in età pediatrica ed i reperti ecografici che possono condurre alla corretta diagnosi di processi patologici.

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Authors and Affiliations

  1. Radiology Department, “Antonio Cardarelli” Hospital, Naples, Italy

    Marco Di Serafino & Ciro Acampora

  2. Paediatric Radiology Department, “Federico II” University Hospital, Naples, Italy

    Francesco Verde & Gianfranco Vallone

  3. Radiology Department, Regional Hospital of Bolzano, Bolzano, Italy

    Federica Ferro & Norberto Vezzali

  4. Radiology Department, “Santobono-Pausilipon” Children Hospital, Naples, Italy

    Eugenio Rossi

  5. Radiology and Neuroradiology Imaging Diagnostic Department, Agostino Gemelli” University Hospital, IRCCS, Rome, Italy

    Iacopo Valente

  6. Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy

    Piernicola Pelliccia

  7. Department of Radiology, Sacro Cuore” University Hospital, Rome, Italy

    Stefania Speca

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  1. Marco Di Serafino
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Correspondence to Francesco Verde.

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Di Serafino, M., Verde, F., Ferro, F. et al. Ultrasonography of the pediatric spleen: a pictorial essay. J Ultrasound 22, 503–512 (2019). https://doi.org/10.1007/s40477-018-0341-2

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