SPLENIC ARTERY ANEURYSM - VALUE OF COLOR DOPPLER AND THE LIMITATION OF GRAY-SCALE ULTRASONOGRAPHY

Background: To reevaluate the advantages and limitations of gray-scale and color Doppler sonography in the diagnosis of splenic artery (Sp-A ) aneurysm. Methods: We reviewed the gray-scale and color Doppler sono gram's of five cases with Sp-A aneurysm (four patients with portal hyp ertension and one patient without portal hypertension). Color Doppler sonography was performed in all five:patients, and power Doppler sonog raphy was performed in three. Results: Gray-scale. sonography failed t o detect the aneurysm in four of five cases because of a surrounding s plenorenal (Sp-R) shunt in three patients and marked calcification of the aneurysmal wall in one-patient. Pulsed Doppler sonography showed a slightly turbulent pulsatile-flow :along the aneurysmal wall, which i mmediately led to the diagnosis:in four cases, including the three cas es with Sp-R shunt, In one case, color Doppler sonography failed to de tect the aneurysm because of a markedly calcified aneurysmal wall, alt hough power Doppler sonography could visualize the aneurysm. Conclusio ns: Gray-scale sonography is not a useful diagnostic tool for Sp-A ane urysm. Clinicians should use color Doppler sonography in the evaluatio n of the splenic hilus in patients with Sp-R shunt to find a small Sp- A aneurysm. The addition of power Doppler sonography is helpful in vis ualizing calcified Sp-A aneurysms