title: Use of contrast-enhanced ultrasound for characterization of focal splenic lesions.
abstract: Contrast-enhanced ultrasound was used to study focal and multifocal lesions of the spleen in 26 dogs and two cats affected by 11 benign and 18 malignant splenic diseases. A second-generation microbubble contrast medium (Sonovue) was injected into the cephalic vein and enhancement patterns were subjectively described and time intensity curves calculated. Final diagnosis was obtained by histopathologic examination after splenectomy (n=19) or by needle aspiration and sonographic follow-up after 4 and 8 weeks (n=9). Contrast-enhanced ultrasound parameters, improving the characterization between benign and malignant lesions, were established. The most useful criterion was the hypoechogenicity of the lesion in the wash-out phase combined with the presence of tortuous feeding vessels, which was observed in association with malignancy. All malignant lesions were hypoechoic to the surrounding spleen 30s after starting the contrast medium injection. Lymphosarcoma and hemangiosarcoma had characteristic perfusion patterns. Lymphosarcoma had rapid time to peak and early wash-out phase with a honeycomb pattern during the wash-out. Hemangiosarcomas were large nonperfused masses in all phases surrounded by hypervascular splenic parenchyma. Benign lesions except one hematoma and a benign histiocytoma had the same perfusion pattern as the surrounding spleen. Ultrasonographic and contrast-enhanced ultrasound findings of an accessory spleen are reported. Contrast-enhanced ultrasound can improve the characterization of focal or multifocal lesions of the spleen.
authors.affiliation: Veterinary Clinic dell'Orologio-Via Gramsci 1/4, 40037 Sasso Marconi, Bologna, Italy. chiccarossi@yahoo.it
authors.forename: Federica
authors.initials: F
authors.lastname: Rossi
authors.forename: Vito Ferdinando
authors.initials: VF
authors.lastname: Leone
authors.forename: Massimo
authors.initials: M
authors.lastname: Vignoli
authors.forename: Etser
authors.initials: E
authors.lastname: Laddaga
authors.forename: Rossella
authors.initials: R
authors.lastname: Terragni
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002415:Cats; D004283:Dog Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004285:Dogs; D005260:Female; D008297:Male; D010743:Phospholipids; D013156:Splenectomy / Q000662:veterinary; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary*; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride