Journal of Ultrasound in Medicine, Vol 12, Issue 6 349-353, Copyright © 1993 by American Institute of Ultrasound in Medicine
Dilation of venous vessels at the splenic hilum in normal sized spleens as an indication of pathologic splenic involvement: preliminary results
S. M. Stella, S. Giunta, F. Galetta, G. Cini and C. Giusti
Istituto di Clinica Medica II, Universita di Pisa, Italy.
Twelve hundred patients without liver or heart disease, having a normal
sized spleen without focal lesions, were examined by ultrasonography to
measure the inner diameter of the splenic vein in relation to possible
current or recent recovery from pathologic processes. SVD was measured at
the hilum of the spleen with the patients supine. Ten of the patients in
whom dilation of the SVD was found, together with a group of healthy
controls (25), were subsequently studied with a duplex Doppler analysis to
measure the venous outflow from the spleen. The results showed 1,175
spleens (98%) with SVD at the hilum of < 8 mm and 25 spleens (2%) with
SVD of > 8 mm. Twenty-three of 25 patients (92%) with enlarged SVD had
recent histories of hematopoietic or infectious diseases. Ten of 23
patients with enlarged SVD were studied further with a Doppler analysis.
They demonstrated a rapid splenic blood flow with maximum flow velocities
ranging from 14 to 27 cm/sec and high outflow volumes (from 430 to 1,227
ml/min, averaging 786 ml/min +/- 266), both significantly increased in
comparison with controls (outflow volume from 200 to 355 ml/min, averaging
274 +/- 40; P < 0.0001). We conclude that dilation of the SVD
accompanied by an increased intrasplenic blood flow volume without splenic
enlargement would indicate a state of increased perfusion of splenic tissue
associated with an immune response, reflecting reaction of the spleen to
disease.
