Role of Doppler sonography in the evaluation of accessory spleens after splenectomy

Objective. Splenectomy influences the Doppler blood flow pattern in the spl enic artery. Blood flow in this vessel might return to normal if an accesso ry spleen increases in size after splenectomy Our objective was to evaluate the resistive index of the splenic-artery depending on the presence or abs ence of a hypertrophic accessory spleen in splenectomized patients. Methods . The resistive index of the splenic artery was evaluated by duplex Doppler sonography in 19 splenectomized patients (8 with a hypertrophic accessory spleen) and in 8 healthy volunteers. The resistive index Was measured withi n 3 cm of the origin of the splenic artery 4 and 3 different measurements w ere averaged. The presence or absence of a hypertrophic accessory spleen wa s diagnosed on the basis of sonography, computed tomography, magnetic reson ance imaging, or scintigraphy, as well as by the presence or absence of How ell-Jolly bodies on a peripheral blood smear. Results. The resistive index of the splenic artery in the splenectomized patients without a hypertrophic accessory spleen (mean +/- SD, 0.82 +/- 0.06; n = 11) was significantly (P less than or equal to .0001) higher than in splenectomized patients with a hypertrophic accessory spleen (0.63 +/- 0.06; n = 8) and in control subjec ts (0.63 +/- 0.05; n = 8). Conclusions. In the splenectomized patient, a hy pertrophic accessory spleen is associated with a normal resistive index in the splenic artery.