Image-guided percutaneous splenic interventions.

Abstract

In the spleen, image-guided interventional procedures such as biopsy and catheter drainage have not been widely performed because of the perceived increased risk of complications. The ability of image-guided biopsy to allow tissue diagnosis of a focal splenic mass without the need for splenectomy is the driving force behind use of this procedure in oncology patients. The literature on image-guided splenic biopsy suggests that the highest biopsy yield is achieved with core biopsy and the lowest complication rate is achieved with fine-needle aspiration. Image-guided catheter drainage is an effective alternative to splenectomy for management of infected splenic collections. In clinical practice, image-guided splenic biopsy, fluid aspiration, and catheter drainage have high success rates. Image-guided alcohol ablation is effective in treatment of splenic cysts. The literature on splenic radiofrequency ablation (RFA) is sparse; therefore, further studies are needed to determine the role of RFA in management of splenic neoplasms and hypersplenism. Image-guided percutaneous thrombin injection can be used to treat splenic artery pseudoaneurysms. Awareness of the correct interventional techniques and their limitations is important for safe performance of image-guided percutaneous splenic interventions.

• Authors: Ajay K Singh, Sridhar Shankar, Debra A Gervais, Peter F Hahn, Peter R Mueller
• Journal: Radiographics : a review publication of the Radiological Society of North America, Inc (Radiographics) 2012 Mar-Apr Vol. 32 Issue 2 Pg. 523-34 ISSN: 1527-1323 [Electronic] United States
• PMID: 22411947 (Publication Type: Journal Article, Review)

Chemical References

• Sclerosing Solutions
• Ethanol

Topics

• Aneurysm, False (diagnostic imaging, therapy)
• Biopsy, Needle (adverse effects, methods)
• Catheter Ablation
• Catheterization (methods)
• Drainage (instrumentation, methods)
• Embolization, Therapeutic (methods)
• Ethanol (administration & dosage, therapeutic use)
• Humans
• Magnetic Resonance Imaging, Interventional
• Pneumothorax (etiology)
• Postoperative Complications (etiology)
• Postoperative Hemorrhage (etiology)
• Preoperative Care
• Radiography, Interventional (methods)
• Sclerosing Solutions (administration & dosage, therapeutic use)
• Sclerotherapy (methods)
• Spleen (pathology, surgery)
• Splenic Artery
• Splenic Diseases (diagnosis, pathology, surgery)
• Surgery, Computer-Assisted (methods)
• Tomography, X-Ray Computed (methods)
• Ultrasonography, Interventional