title: Image-guided percutaneous splenic interventions.
abstract: In the spleen, image-guided interventional procedures such as biopsy and catheter drainage have not been widely performed because of the perceived increased risk of complications. The ability of image-guided biopsy to allow tissue diagnosis of a focal splenic mass without the need for splenectomy is the driving force behind use of this procedure in oncology patients. The literature on image-guided splenic biopsy suggests that the highest biopsy yield is achieved with core biopsy and the lowest complication rate is achieved with fine-needle aspiration. Image-guided catheter drainage is an effective alternative to splenectomy for management of infected splenic collections. In clinical practice, image-guided splenic biopsy, fluid aspiration, and catheter drainage have high success rates. Image-guided alcohol ablation is effective in treatment of splenic cysts. The literature on splenic radiofrequency ablation (RFA) is sparse; therefore, further studies are needed to determine the role of RFA in management of splenic neoplasms and hypersplenism. Image-guided percutaneous thrombin injection can be used to treat splenic artery pseudoaneurysms. Awareness of the correct interventional techniques and their limitations is important for safe performance of image-guided percutaneous splenic interventions.
authors.affiliation: Department of Radiology, Division of Emergency Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA. mghpartners@yahoo.com
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Singh
authors.forename: Sridhar
authors.initials: S
authors.lastname: Shankar
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gervais
authors.forename: Peter F
authors.initials: PF
authors.lastname: Hahn
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mueller
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D017115:Catheter Ablation; D002404:Catheterization / Q000379:methods; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D011030:Pneumothorax / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D011300:Preoperative Care; D015641:Radiography, Interventional / Q000379:methods; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods; D013154:Spleen / Q000473:pathology* / Q000601:surgery; D013157:Splenic Artery; D013158:Splenic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol