Pseudo perisplenic "fluid collections": a clue to normal liver and spleen echogenic texture

In a number of cases the ultrasound examination of the left upper quadrant showed an appearance suggesting a fluid collection around the superior and lateral aspects of the spleen. Subsequent investigations including careful real-time evaluation, computed tomography, and magnetic resonance imaging have demonstrated that the pseudo-"fluid collection" is the normal left lobe of the liver extending into the left subdiaphragmatic space to lie superior and even lateral to the spleen. The echogenicity of the normal liver was observed to be less than that of the normal spleen. The ability to simultaneously visualize both the liver and the normal spleen at the same depth and the same field of view gives a true indication of the relative echogenic consistency of the liver and the spleen, which is different from that which had been previously reported.