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FUNDAMENTALS OF BODY CT > Spleen > Flashcards

Spleen Flashcards

1
Q

Spleen CT protocol

A
  1. Non-Contrast
  2. Arterial phase (30 sec)
  3. Portal venous phase (60 sec)
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2
Q

Spleen anatomic anomalies

A
  1. Accesory spleen (splenules)
  2. Wandering spleen
  3. Splenic Regeneration/Splenosis
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3
Q

Splenomegaly Definition and causes

A
  • Splenomegaly: Size >12 cm.
  • Massive splenomegaly: >20 cm.
  • Causes: Myeloproliferative, infective, inflammatory, congestive and infiltrative categories.
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4
Q

Spleen Cystic lesions (4)

A
  1. Posttraumatic Cysts.
  2. Congenital epithelium-lined cysts.
  3. Echinoccocal cysts.
  4. Pancreatic pseudocysts.
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5
Q

Posttraumatic splenic cysts

A

-80% of all splenic cysts.
- Secondary to previous: hemorrage, infarction or infection.
- CT findings: Wall of variable thickness, internal debris, fluid levels, milk of calcium and calcification of the wall (30-40%).

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6
Q

Congenital epithelium-lined splenic cysts

A
  • True cysts with epithelium wall
  • 20% of all splenic cysts
  • CT findings: well-defined, water density, spherical, usually unilocular cyst with thin wall
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7
Q

Echinoccocal splenic cysts

A
  • Rare, only 2% of patients with hydatid disease.
  • Larger mother cyst containing smaller daughter cysts near the periphery.
  • Ring-like calcifications of the walls are common.
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8
Q

Pancreatic pseudocysts (Spleen)

A
  • Secondary to pancreatitis fluid gaining access to the splenic parenchyma
  • CT findings: Subcapsular fluid collection of water attenuation + pancreatitis
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9
Q

Spleen infarction

A
  • Asymptomatic or left quadrant pain
  • Causes: Atherosclerosis, arteritis, tumor, pancreatitis, systemic emboli or sickle disease
  • Splenomegaly = Risk factor
  • CT findings: Wedge-shaped low-attenuation defect that extends to the splenic capsule
  • Also might not be wedge-shaped
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10
Q

Splenic Bacterial abcesses

A
  • Uncommon
  • Immune system compromise, diabetes or IV drug abuse
  • CT findings: Single or multiple low-density areas with ill-defined walls, which might be thickened and enhance with contrast, internal attenuation 20-40 UH, fluid level
  • 20% might contain gas
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11
Q

Splenic microabscesses

A
  • Immunocompromised: AIDS, QT, lymphoma, leukemia, organ transplantation
  • Opportunistic infection: Fungal (candida, pneumocystis jiroveci, aspergilllus, cryptococcus, histoplasma)
  • Rare: CMV or mycobacterium tuberculosis
  • CT findings: Multiple low-density 2-10 mm defects
  • DD: Lymphoma, kaposi sarcoma, sarcoidosis and metastases
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12
Q

Spleen lymphoma

A
  • Primary is rare
  • Secondary is more common: 1/3 of patients with lymphoma have splenic involvement
  • The most common malignant tumor of the spleen
  • CT findings: Multiple lesions (most characteristic) or diffuse infiltration, a solitary large mass might be a confluent deposit of lymphomatous tissue
  • Might infarct
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13
Q

Spleen Metastases causes

A
  1. Melanoma
  2. Lung
  3. Breast
  4. Ovarian
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14
Q

Spleen metastases generalities

A
  • Only 2-9% of patients with widespread malignancies
  • 50% caused by melanoma
  • CT findings: ill-defined, low density, but no water density, nodules with some degree of periptheral enhancement
  • Melanoma: cystic metastases
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15
Q

Spleen sarcoidosis

A
  • 5-15% of patients
  • Splenomegaly or single /multiple low-attenuation nodules with indistinct margins
  • Local lymphadenopathy might be present
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16
Q

Spleen Hemangioma

A
  • Most common benign neoplasm of the spleen (still rare)
  • Cystic or solid on unenhanced CT
  • 1 to 15 cm size
  • Central Punctate calcifications may be present or peripheral curvilinear calcifications
  • Klippel-tranaunay-weber syndrome is associated with multiple spleen hemangiomas that look cystic
  • Might enhance during arterial phase.
17
Q

Spleen Lymphangioma

A
  • Uncommon splenic tumor
  • Asymptomatic
  • Benign, slow growing
  • Small, multiple, homogeneous, cystic lesions, 15-35 UH, hypovascular, subcapsular
18
Q

Spleen Hamartoma

A
  • Rare
  • Similar to spleen hemangioma
  • Beningn lesion
  • CT: Low attenuation to isointense, slow enhancement, isodense on delayed phase
19
Q

Spleen Angiosarcoma

A
  • Rare malignancy
  • Agressive
  • Widespread metastases: Lung, bone, liver
  • CT: Multiple enhancing nodules with irregular and poorly defined contours, might also appear as a complex mass of cystic and solid components that enhances irregularly
  • Splenomegaly usually present
20
Q

Splenic calcifications

A
  • Common, usually from histoplasmosis or tuberculosis
  • Multiple small focal calcifications
  • Larger might be from: previous infection, infarction or trauma.

FUNDAMENTALS OF BODY CT (8 decks)

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