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Intrapancreatic accessory spleen: evaluation by CT arteriography
S Miyayama1, O Matsui, T Yamamoto
1Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
Abdominal Imaging
|February 3, 2004
Summary
Computed tomographic arteriography (CTA) can help differentiate intrapancreatic accessory spleens from pancreatic tumors. Characteristic CTA findings, including inhomogeneous enhancement and a deep cleft, aid in diagnosis, potentially avoiding unnecessary surgery.
Area of Science:
- Radiology
- Abdominal Imaging
- Vascular Imaging
Background:
- Intrapancreatic accessory spleens are often misdiagnosed as pancreatic tumors.
- Accurate differentiation is crucial to prevent unnecessary surgical interventions.
Purpose of the Study:
- To evaluate the utility of computed tomographic arteriography (CTA) in diagnosing intrapancreatic accessory spleens.
- To identify characteristic CTA findings that distinguish these lesions from pancreatic neoplasms.
Main Methods:
- CTA was performed, including digital subtraction angiography with celiac artery contrast injection.
- Dynamic single-level CTA with continuous scanning was utilized in two cases.
Main Results:
- CTA revealed early, inhomogeneous enhancement of the lesion, mirroring splenic parenchyma.
- Dynamic CTA showed diminished enhancement in later phases.
- Multiplanar reformatted images demonstrated a deep cleft, suggesting an extrapancreatic origin.
Conclusions:
- Inhomogeneous enhancement and a deep cleft are key CTA findings for diagnosing intrapancreatic accessory spleen.
- These imaging features can aid in confirming the diagnosis and guiding clinical management.