To compare the value of US and CT for the detection and analysis of sp
lenic abnormalities, we reviewed the medical records and imaging findi
ngs of 93 patients with 93 proven textural lesions of the spleen, whic
h were visualized by VS and/or CT. US revealed the abnormality in 91 (
97.8%) patients and CT in 74 (79.6%) patients. US was more sensitive t
han CT in the detection of malignant lesions, particularly splenic lym
phoma, while US and CT were equally effective in benign lesions. In 2
patients, one with sarcoidosis and the other with an acute infarct, th
e lesion was visualized by CT but not by US. On CT, i.v. injection of
contrast material improved both the sensitivity of the examination and
the delineation of the abnormality. The echogenicity or the attenuati
on of the lesions did not usually allow differentiation between the va
rious benign and malignant splenic lesions. US is recommended as the m
ethod of choice for splenic imaging.