Splenic ultrasound evaluates spleen size, echogenicity, and focal lesions in the context of hematologic disease, abdominal trauma, and portal hypertension. While often performed as part of a comprehensive abdominal examination, the spleen may be the primary focus in hematology oncology evaluations.
Sonographers measure splenic length, width, and thickness to calculate volume, providing objective data for splenomegaly grading. Normal splenic length is less than 12 cm; values above 20 cm indicate massive splenomegaly. Common findings include splenomegaly from lymphoma, leukemia, mononucleosis, sickle cell disease, and portal hypertension. Focal lesions including splenic cysts, hemangiomas, lymphoma infiltration, and post-traumatic infarcts are characterized. Doppler assessment of the splenic vein is included when portal hypertension is suspected.
Splenic imaging is included in the ARDMS Abdomen (AB) specialty within the RDMS credential. Sonographers see splenic pathology across general abdominal, emergency, and hematology settings. Familiarity with the spectrum of splenic echogenicity and the clinical contexts driving the examination is essential for high-quality reporting.