AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kim, S. H.
Right arrow Articles by Choi, B. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kim, S. H.
Right arrow Articles by Choi, B. I.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Contrast-Enhanced Sonography of Intrapancreatic Accessory Spleen in Six Patients

Se Hyung Kim1, Jeong Min Lee1,2, Jae Young Lee1, Joon Koo Han1,2 and Byung Ihn Choi1,2

1 Department of Radiology, Seoul National University Hospital and College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
2 Institute of Radiation Medicine, Seoul National University Hospital and College of Medicine, Seoul 110-744, Korea.


Figure 1
View larger version (115K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1A —45-year-old man with intrapancreatic accessory spleen detected incidentally during workup for small-bowel submucosal tumor (patient 1). Axial CT image obtained in portal venous phase shows ovoid, well-enhanced nodule (arrow) in pancreatic tail. Attenuation of this lesion is hyperattenuated to pancreas and similar to that of spleen (S).

 

Figure 2
View larger version (103K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1B —45-year-old man with intrapancreatic accessory spleen detected incidentally during workup for small-bowel submucosal tumor (patient 1). Transverse gray-scale sonography image shows homogeneous and isoechoic nodule (large arrows) with subtle hyperechoic rim and posterior acoustic enhancement (double arrows) in tail of pancreas (arrowheads). Echogenicity of this lesion is similar to that of pancreas (arrowheads) and spleen (S).

 

Figure 3
View larger version (103K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1C —45-year-old man with intrapancreatic accessory spleen detected incidentally during workup for small-bowel submucosal tumor (patient 1). On vascular phase contrast-enhanced sonogram obtained 6 seconds after arrival of contrast material, feeding pedicle (arrowhead) enters into intrapancreatic accessory spleen (arrow). Degree and pattern of enhancement of this lesion were similar to those of main spleen (not shown). LK = left kidney.

 

Figure 4
View larger version (114K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1D —45-year-old man with intrapancreatic accessory spleen detected incidentally during workup for small-bowel submucosal tumor (patient 1). Serial contrast-enhanced agent detection imaging (ADI software, Siemens Medical Solutions) sonograms, obtained 34 seconds (upper left), 101 seconds (upper right), and 4 minutes (lower images) after contrast injection, show homogeneous enhancement of intrapancreatic accessory spleen (arrows) on postvascular phases (upper images) and delayed prolonged enhancement (arrow) on hepatosplenic parenchymal phase (lower left). Degree of enhancement of intrapancreatic accessory spleen (arrow, lower left) on hepatosplenic parenchymal phase is similar to that of main spleen (S). LK = left kidney.

 

Figure 5
View larger version (40K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1E —45-year-old man with intrapancreatic accessory spleen detected incidentally during workup for small-bowel submucosal tumor (patient 1). Axial 99mTc heat-damaged RBC SPECT image shows clear accumulation of radionuclide (arrow) near splenic hilum and confirms diagnosis of intrapancreatic accessory spleen. L = liver, S = spleen.

 

Figure 6
View larger version (108K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2A —70-year-old woman with intrapancreatic accessory spleen (patient 4). Baseline gray-scale sonography shows round nodule (single arrow) 1.1 cm in diameter in pancreatic tail. This lesion has lower echotexture than pancreas (arrowheads) and similar echotexture to that of spleen (S). Note peripheral high-echoic rim surrounding lesion and acoustic enhancement (double arrows) posterior to lesion.

 

Figure 7
View larger version (87K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2B —70-year-old woman with intrapancreatic accessory spleen (patient 4). On color Doppler sonography, vascular hilum (open arrow) around lesion (solid arrow) is suspected but is not definite.

 

Figure 8
View larger version (99K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2C —70-year-old woman with intrapancreatic accessory spleen (patient 4). Contrast-enhanced sonogram obtained 9 seconds after first arrival of contrast material to splenic artery clearly shows feeding pedicle (open arrows) entering into intrapancreatic accessory spleen (solid arrow) from splenic artery.

 

Figure 9
View larger version (110K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2D —70-year-old woman with intrapancreatic accessory spleen (patient 4). Serial contrast-enhanced agent detection imaging (ADI software, Siemens Medical Solutions) sonograms, obtained 23 seconds (upper left), 37 seconds (upper right), 84 seconds (lower left), and 4 minutes (lower right) after contrast administration, show early heterogeneous enhancement (upper), late homogeneous enhancement (lower left), and delayed homogeneous and prolonged enhancement (lower right). Intrapancreatic accessory spleen (arrow) shows almost same echogenicity to main spleen (S) on all contrast-enhanced sonography phases. Both intrahepatic accessory spleen and main spleen show higher echogenicity than pancreas on all contrast-enhanced sonography phases.

 

Figure 10
View larger version (144K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2E —70-year-old woman with intrapancreatic accessory spleen (patient 4). On unenhanced MR images, intrapancreatic accessory spleen (arrow) shows low signal intensity on T1-weighted image (E) and high signal intensity on fatsaturated T2-weighted image (F).

 

Figure 11
View larger version (148K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2F —70-year-old woman with intrapancreatic accessory spleen (patient 4). On unenhanced MR images, intrapancreatic accessory spleen (arrow) shows low signal intensity on T1-weighted image (E) and high signal intensity on fatsaturated T2-weighted image (F).

 

Figure 12
View larger version (142K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2G —70-year-old woman with intrapancreatic accessory spleen (patient 4). Superparamagnetic iron oxide (SPIO)-enhanced T2*-weighted image obtained 10 minutes after SPIO administration shows signal drop similar in degree to that in lesion (arrow) and spleen (S).

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Roentgen Ray Society.