LIEN/SPLEN/LIMPA

Oleh:
Naomi R. Claudya Napitupulu
213210169
FK UMI 2013

SMF RADIOLOGI
RSUD DR PIRNGADI MEDAN
RADIOGRAPHIC APPEARANCE
Ultrasound
1. Best assessed in the supine, left lateral position with the left arm
placed behind the head
2. Visualized best obliquely in the 9th or 10th intercostal spaces
3. Echogenicity usually higher when compared to the liver, but may
be iso- or hypoechoic

CT
1. Splenic parenchyma should be be assessed in portal venous phase
as inhomogeneous splenic enhancement (zebra or psychedelic
spleen) seen on arterial phase can mimic splenic lacerationor
contusion
SPLEN
The spleen is an organ of the haematological system and has a role in
immune response, storage of red blood cells and hematopoiesis.

The spleen is a wedge-shaped organ lying mainly in the left upper

quadrant (left hypochondrium and partly in the epigastrium) and is
protected by the left 9th to 11th ribs. It is soft, highly vascular and
dark purple in colour.
 GROSS ANATOMY
Size and weight vary from person-to-
person but on average is around 2.5 cm
thick, 7.5 cm broad and 12.5 cm in
length.

The spleen has two poles (superior and inferior),

three borders and two surfaces (diaphragmatic
and visceral). It is enclosed by a thin capsule,
which is easily ruptured.

The spleen is completely covered by peritoneum, except at the hilum, and

forms a number of ligaments :
gastrosplenic ligament
attaches the spleen to the greater curvature of the stomach
contains short gastric and left gastroepiploic arteries
splenorenal ligament
attaches the spleen to the left kidney
contains splenic artery and vein and the pancreatic tail
ANATOMI SPLEN
FOTO ABDOMINAL SPLEN NORMAL
POSISI AP SUPINE
ANATOMI SPLEN
CT SCAN ABDOMEN SAGITTAL
POSITION
ANATOMI SPLEN
CT-SCAN ABDOMEN NORMAL
ANATOMI SPLEN
CT-SCAN ABDOMEN NORMAL
NORMAL SPLEN IN ULTRASONOGRAPHY
DISEASE OR MEDICAL CONDITIONS

SPLENOMEGALY
SPLENIC DISEASE
SPLENIC INJURY
SPLENIC INFARCTION
INFECTIOUS MONONUCLEOSIS
GAUCHERS DISEASE
ASPLENIA
SPHEROCYTOSIS
HEREDITARY SPHEROCYTOSIS
WANDERING SPLEEN
ACCESORY SPLEEN
PORTAL HYPERTENSION
LYMPHANGIOMATOSIS
SPLENIC TUMOR
MYELOFIBROSIS
SPLENOMEGALY
Splenomegaly is a term which refers to enlargement of the
spleen. The normal adult splenic length upper limit is usually
around 12-15 cm.
RADIOGRAPHIC FEATURES
The shape and orientation of a spleen makes accurate linear
measurement difficult.

On CT, a splenic width measurement (largest anterior-posterior

measurement on axial images) of greater than 10.5 cm is the
most accurate single measurement for mild to moderate
splenomegaly, while a cranial-caudal height measurement of
greater than 14.6 cm is the most accurate single measurement for
massive splenomegaly.

On sonographic assessment, a length of 12 cm is generally

considered the upper limit of normal.
SPLENOMEGALY

Splenomegaly in ultrasound
Splenomegaly with cirrhotic liver
Splenomegaly in ultrasound
 S

Computed to tomographic section of abdomen

 Splenic involvement in
Non-Hodgkin Lymphoma

S
 Any situations of splenomegaly:
AIDS
Splenomegaly associated with generalized lymphoid hyperplasia is the most
common finding in patients with AIDS.
Focal lesions in the spleen are usually caused by opportunistic infections such
as pneumocytes, pneumocytis jiroveci, atypical mycobacterium, or Candida.
AIDS-associated lymphoma and Kaposi sarcoma may also cause single or
multiple solid-appearing lesions in the spleen.

Fetal splenomegaly
(or simply an enlarged fetal spleen) can arise from a number of situations. It
can occur with or without fetal hepatomegaly.

These include
in utero infection
in utero parvovirus B19 infection
in utero cytomegalovirus infection 1
inborn errors of metabolism
Gaucher disease 2
Neimann-Pick disease 2
in association with fetal hydrops
SPLENIC DISEASE
SPLENIC INJURY
GRADING SPLEN INJURY
ACCESORY SPLEEN
ACCESORY SPLEEN IN
ULTRASOUND
SPLENIC REGENERATION
SPLENIC INFARCTION
Splenic infarction with a wedge shape non vascularized splenic lession
Splenic infarct with a non vascularized wedge shaped
hypoechoic area
SPLEEN INFARCTION IN CT-SCAN