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A pattern-oriented approach to splenic imaging in infants and children
A Paterson1, D P Frush, L F Donnelly
1Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Insights
This study introduces a pattern-oriented imaging approach for diagnosing pediatric spleen abnormalities. It categorizes anomalies by shape, location, number, size, and lesion type for improved diagnostic accuracy.
Area of Science:
- Pediatric Radiology
- Abdominal Imaging
- Spleen Imaging
Background:
- The spleen in infants and children is frequently affected by various pathologies, either in isolation or as part of systemic diseases.
- Accurate diagnosis of splenic abnormalities in children is crucial for appropriate management.
Purpose of the Study:
- To develop and present a pattern-oriented approach for the imaging evaluation of the pediatric spleen.
- To aid in the differential diagnosis of splenic abnormalities in children.
Main Methods:
- Categorization of splenic anomalies based on imaging patterns: shape, location, number, size, solitary lesions, multiple focal lesions, and diffuse disease.
- Utilized various imaging modalities including computed tomography, magnetic resonance imaging, ultrasound, and technetium-99m scintigraphy.
Main Results:
- Splenic anomalies were systematically classified into distinct radiologic patterns.
- The imaging appearance of the pediatric spleen is influenced by patient age and the imaging modality employed.
Conclusions:
- A pattern-oriented approach facilitates the differential diagnosis of pediatric splenic abnormalities.
- Familiarity with the spectrum of radiologic patterns aids in correct diagnosis and timely treatment of pediatric splenic conditions.
Abstract:
The spleen in infants and children is commonly involved in a variety of pathologic processes. Some of these processes cause isolated splenic disease, whereas others involve the spleen as part of a systemic illness. To facilitate differential diagnosis of splenic abnormalities, a pattern-oriented approach to the imaging evaluation of the pediatric spleen was developed. With this approach, splenic anomalies are categorized as anomalies of splenic shape (clefts, notches, lobules), location (eg, wandering spleen), number (polysplenia, asplenia), or size (splenomegaly, splenic atrophy); solitary lesions (eg, cysts, lymphangiomas, hemangiomas, hamartomas); multiple focal lesions (eg, trauma, infection and inflammation, neoplasms, storage disorders); and diffuse disease without focal lesions (eg, infarction, heavy metal deposition, hemangioendotheliomas, peliosis). A variety of imaging modalities can be used in splenic assessment, including computed tomography, magnetic resonance imaging, ultrasound, and technetium-99m scintigraphy. The imaging appearance of the pediatric spleen depends on the patient's age and the modality used; however, familiarity with the spectrum of radiologic patterns of splenic involvement will facilitate correct diagnosis and prompt treatment.