From the Research
Ultrasound is the recommended initial diagnostic imaging modality for evaluating splenomegaly. This non-invasive technique provides excellent visualization of the spleen, allowing accurate measurement of its size and assessment of its parenchymal texture. The most recent and highest quality study, 1, published in 2024, highlights the role of multiparametric ultrasound in the evaluation of splenic pathologies, including splenomegaly. According to this study, ultrasound evaluation of the spleen is mandatory in the assessment of patients with chronic liver disease, and splenomegaly can be a sign of systemic diseases.
Key Benefits of Ultrasound
- Readily available and cost-effective
- Does not use ionizing radiation
- Can be performed quickly at the bedside if necessary
- Provides excellent visualization of the spleen, allowing accurate measurement of its size and assessment of its parenchymal texture
Ultrasound Findings
- Measure the spleen in multiple dimensions, with a length exceeding 13 cm generally considered enlarged in adults
- Detect focal lesions within the spleen
- Evaluate surrounding structures
- Assess for potential causes of splenomegaly, such as portal hypertension, by examining portal vein flow
Further Imaging
If ultrasound findings are inconclusive or more detailed characterization is needed, further imaging with CT or MRI may be warranted as second-line options. These advanced modalities provide additional information about the composition of splenic lesions and better visualization of surrounding structures but are typically reserved for cases requiring more comprehensive evaluation after the initial ultrasound assessment, as noted in 2, 3, and 4. However, the most recent study 1 emphasizes the importance of multiparametric ultrasound, which may reduce the need for invasive procedures and ensure appropriate patient management.