Jarvis L, Cook P G, James C M, Rose M, Prentice A G, Dubbins P A
Department of Diagnostic Ultrasound, Plymouth Group Hospital, UK.
Br J Radiol. 1991 Jun;64(762):485-8. doi: 10.1259/0007-1285-64-762-485.
The aetiology of splenomegaly is seldom clear from either clinical or imaging assessment of the spleen. In the majority of cases sonographic assessment of the spleen produces a homogeneous enlargement of variable echodensity, but with very poor correlation with pathology. A study has been undertaken to assess the Doppler characteristics of the splenic artery in splenomegaly, excluding cases of portal hypertension in an attempt to provide further diagnostic information. Duplex assessment of 18 normal subjects and 10 patients with splenomegaly due to five different causes was undertaken. Analysis of waveform, peak frequency and pulsatility index were compared and failed to demonstrate any significant change. In the normal subject there is a broad systolic spectrum related to the tortuosity of the splenic artery, with persistence of forward flow throughout diastole, a reflection of the low peripheral resistance of the spleen. In splenomegaly the broad systolic spectrum is unchanged, since vessel tortuosity persists. Pathological and physiological assessment of the spleen in splenomegaly shows that a low resistance circulation persists, explaining maintenance of the diastolic flow pattern in splenomegaly. Increased blood flow to the spleen in splenomegaly occurs either as a result of an increase in vessel diameter or an increase in flow velocity, or a variable combination of the two which does not seem to be governed by specific pathology. An increase in peak frequency in some cases reflected some increase in flow velocity but provided no useful correlation. Analysis of the pulsatility index supported the above findings without adding further information.
无论是通过对脾脏进行临床评估还是影像评估，脾肿大的病因很少能明确。在大多数情况下，脾脏的超声评估显示脾脏均匀增大，回声密度各异，但与病理结果的相关性很差。本研究旨在评估脾肿大时脾动脉的多普勒特征，排除门静脉高压病例，以试图提供更多诊断信息。对18名正常受试者和10名因五种不同原因导致脾肿大的患者进行了双功超声评估。对波形、峰值频率和搏动指数进行了分析比较，但未发现任何显著变化。在正常受试者中，由于脾动脉迂曲，收缩期频谱较宽，整个舒张期均有正向血流持续，这反映了脾脏外周阻力较低。在脾肿大时，由于血管迂曲持续存在，收缩期宽频谱不变。对脾肿大时脾脏的病理和生理评估表明，低阻力循环持续存在，这解释了脾肿大时舒张期血流模式的维持。脾肿大时脾脏血流增加是由于血管直径增加或流速增加，或两者的可变组合，这似乎不受特定病理因素的支配。在某些情况下，峰值频率增加反映了流速有所增加，但未提供有用的相关性。搏动指数分析支持上述发现，但未提供更多信息。
