Image-guided percutaneous splenic interventions

Radiographics. 2012 Mar-Apr;32(2):523-34. doi: 10.1148/rg.322115135.

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.

Publication types

  • Review

MeSH terms

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

Substances

  • Sclerosing Solutions
  • Ethanol