DILATION OF VENOUS VESSELS AT THE SPLENIC HILUM IN NORMAL SIZED SPLEENS AS AN INDICATION OF PATHOLOGICAL SPLENIC INVOLVEMENT - PRELIMINARY-RESULTS

Twelve hundred patients without liver or heart disease, having a norma l sized spleen without focal lesions, were examined by ultrasonography to measure the inner diameter of the splenic vein in relation to poss ible current or recent recovery from pathologic processes. SVD was mea sured at the hilum of the spleen with the patients supine. Ten of the patients in whom dilation of the SVD was found, together with a group of healthy controls (25), were subsequently studied with a duplex Dopp ler analysis to measure the venous outflow from the spleen. The result s showed 1,175 spleens (98%) with SVD at the hilum of <8 mm and 25 spl eens (2%) with SVD of >8 mm. Twenty-three of 25 patients (92%) with en larged SVD had recent histories of hematopoietic or infectious disease s. Ten of 23 patients with enlarged SVD were studied further with a Do ppler analysis. They demonstrated a rapid splenic blood flow with maxi mum flow velocities ranging from 14 to 27 cm/sec and high outflow volu mes (from 430 to 1,227 ml/min, averaging 786 ml/min +/- 266), both sig nificantly increased in comparison with controls (outflow volume from 200 to 355 ml/min, averaging 274 +/- 40; P < 0.0001). We conclude that dilation of the SVD accompanied by an increased intrasplenic blood fl ow volume without splenic enlargement would indicate a state of increa sed perfusion of splenic tissue associated with an immune response, re flecting reaction of the spleen to disease.