What should be assessed when examining the spleen on ultrasound?

When examining the spleen on ultrasound, the assessment of size, echogenicity, and the presence of focal lesions or splenomegaly is critical for several reasons.

The size of the spleen is an important indicator of potential pathology; splenomegaly, or an enlarged spleen, can suggest underlying conditions such as infections, hematologic disorders, or portal hypertension. Abnormal echogenicity can indicate various pathological states, such as infiltrative diseases, benign lesions, or malignancies. The detection of focal lesions, such as cysts, abscesses, or tumors, is essential for diagnosing specific conditions and guiding further management.

Evaluating these aspects provides a thorough understanding of the spleen’s health and assists in identifying any abnormalities that might necessitate further investigation or intervention. While considerations like blood flow patterns and the spleen's position and orientation are relevant to a comprehensive examination, the most critical factors for initial assessment focus specifically on size, echogenicity, and the identification of lesions or enlargement.