European Radiology

, 16:1887 | Cite as

MDCT and superparamagnetic iron oxide (SPIO)-enhanced MR findings of intrapancreatic accessory spleen in seven patients

  • Se Hyung Kim
  • Jeong Min LeeEmail author
  • Joon Koo Han
  • Jae Young Lee
  • Won Joon Kang
  • Jin Young Jang
  • Kyung-Sook Shin
  • Kyunghee C. Cho
  • Byung Ihn Choi


The aim of this study is to retrospectively evaluate intrapancreatic accessory spleen (IPAS) with mutidetector computed tomography (MDCT) and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) with emphasis on the role of SPIO-MRI for the diagnosis of IPAS. Seven patients (four men and three women; mean age, 50.7 years) with IPAS underwent quadriphasic MDCT and SPIO-enhanced MRI. IPAS was diagnosed histopathologically (n=2) or by scintigraphy (n=5). Two radiologists evaluated CT and MRI in consensus for the location and size of each lesion and compared its attenuation on CT and signal intensity (SI) on MRI with those of the pancreas and spleen. For quantitative analysis, another radiologist calculated the mean lesional, pancreatic, and splenic attenuations or SIs on MDCT or MRI in each patient. All lesions were located in the pancreatic tail. The average lesion size was 1.5±0.5 cm. All IPASs except one appeared high-attenuating to the pancreas and were isoattenuating to the spleen on all dynamic CT phases. The IPASs were hypointense and hyperintense compared with the pancreas on unenhanced T1- and T2-weighted images, respectively, and their SI was similar to that of the spleen. On SPIO-enhanced, T2-weighted images, a similar degree of signal drop to that of the spleen was noted in all lesions. The results of the quantitative analysis were compatible with those of the subjective analysis. In most IPASs, the attenuation on CT and SI on MRI were identical to those of the spleen, and on SPIO-enhanced MRI, the degree of the signal drop in all lesions was similar to that of the spleen.


Pancreas, CT Pancreas, MR Spleen, abnormalities Contrast media, MR 


  1. 1.
    Halpert B, Gyorkey F (1959) Lesions observed in accessory spleens of 311 patients. Am J Clin Pathol 32:165–168PubMedGoogle Scholar
  2. 2.
    Harris GN, Kase DJ, Bradnock H, Mckinley MJ (1994) Accessory spleen causing a mass in the tail of the pancreas: MR imaging findings. AJR Am J Roentgenol 163:1120–1121PubMedGoogle Scholar
  3. 3.
    Hamada T, Isaji S, Mizuno S, Tabata M, Yamagiwa K, Yokoi H et al (2004) Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor: report of a case. Surg Today 34:878–881PubMedCrossRefGoogle Scholar
  4. 4.
    Hayward I, Mindelzun RE, Jeffrey RB (1992) Intrapancreatic accessory spleen mimicking pancreatic mass on CT. J Comput Assist Tomogr 16:984–985PubMedCrossRefGoogle Scholar
  5. 5.
    Sica GT, Reed MF (2000) Case 27: intrapancreatic accessory spleen. Radiology 217:134–137PubMedGoogle Scholar
  6. 6.
    Ota T, Ono S (2004) Intrapancreatic accessory spleen: diagnosis using contrast enhanced ultrasound. Br J Radiol 77:148–149PubMedCrossRefGoogle Scholar
  7. 7.
    Boraschi P, Donati F, Volpi A, Campori G (2005) Intrapancreatic accessory spleen: diagnosis with RES-specific contrast-enhanced MRI. AJR Am J Roentgenol 184:1712–1713PubMedGoogle Scholar
  8. 8.
    Churei H, Inoue H, Nakajo M (1998) Intrapancreatic accessory spleen: case report. Abdom Imaging 23:191–193PubMedCrossRefGoogle Scholar
  9. 9.
    Ota T, Tei M, Yoshioka A, Mizuno M, Watanabe S, Seki M et al (1997) Intrapancreatic accessory spleen diagnosed by technetium-99m heat-damaged red blood cell SPECT. J Nucl Med 38:494–495PubMedGoogle Scholar
  10. 10.
    Laflamme L, Boucher L (2003) Splenosis detected by heat-denaturated Tc-99m red blood cell scintigraphy. Clin Nucl Med 28:39–42PubMedCrossRefGoogle Scholar
  11. 11.
    Yammine JN, Yatim A, Barbari A (2003) Radionuclide imaging in thoracic splenosis and a review of the literature. Clin Nucl Med 28:121–123PubMedCrossRefGoogle Scholar
  12. 12.
    Ferrucci JT, Stark DD (1990) Iron oxide-enhanced MR imaging of the liver and spleen: review of the first 5 years. AJR Am J Roentgenol 155:943–950PubMedGoogle Scholar
  13. 13.
    Clement O, Frija G, Chambon C, Schouman-Clayes E, Mosnier JF, Poupon MF et al (1991) Liver tumors in cirrhosis: experimental study with SPIO-enhanced MR imaging. Radiology 180:31–36PubMedGoogle Scholar
  14. 14.
    Yamamoto H, Yamashita Y, Yoshimatsu S, Baba Y, Hatanaka Y, Murakami R et al (1995) Hepatocellular carcinoma in cirrhotic livers: detection with unenhanced and iron oxide-enhanced MR imaging. Radiology 195:106–112PubMedGoogle Scholar
  15. 15.
    Seneterre E, Taourel P, Bouvier Y, Pradel J, Van Beers B, Daures JP et al (1996) Detection of hepatic metastases: ferumoxides-enhanced MR imaging versus unenhanced MR imaging and CT during arterial portography. Radiology 200:785–792PubMedGoogle Scholar
  16. 16.
    Weissleder R, Hahn PF, Stark DD, Elizondo G, Saini S, Todd LE et al (1988) Superparamagnetic iron oxide: enhanced detection of focal splenic tumors with MR imaging. Radiology 169:399–403PubMedGoogle Scholar
  17. 17.
    Itoh S, Ikeda M, Achiwa M, Satake H, Iwano S, Ishigaki T (2004) Late-arterial and portal-venous phase imaging of the liver with a multislice CT scanner in patients without circulatory disturbances: automatic bolus tracking or empirical scan delay? Eur Radiol 14:1665–1673PubMedCrossRefGoogle Scholar
  18. 18.
    Pohjonen HK, Savolainen SE, Nikkinen PH, Poutanen VP, Korppi-Tommola ET, Liewendahl BK (1996) Abdominal SPECT/MRI fusion applied to the study of splenic and hepatic uptake of radiolabeled thrombocytes and colloids. Ann Nucl Med 10:409–417PubMedCrossRefGoogle Scholar
  19. 19.
    Paterson A, Frush DP, Donnelly LF, Foss JN, O’Hara SM, Bisset GS 3rd (1999) A pattern-oriented approach to splenic imaging in infants and children. Radiographics 19:1465–1485PubMedGoogle Scholar
  20. 20.
    Poeckler-Schoeniger C, Koepke J, Gueckel F, Sturm J, Georgi M (1999) MRI with superparamagnetic iron oxide: efficacy in the detection and characterization of focal hepatic lesions. Magn Reson Imaging 17:383–392PubMedCrossRefGoogle Scholar
  21. 21.
    Pouliquen D, Le Jeune JJ, Perdrisot R, Ermias A, Jallet P (1991) Iron oxide nanoparticles for use as an MRI contrast agent: pharmacokinetics and metabolism. Magn Reson Imaging 9:275–283PubMedCrossRefGoogle Scholar
  22. 22.
    Donnelly LF, Emery KH, Bove KE, Bissett GS 3rd (1996) Normal changes in the MR appearance of the spleen during early childhood. AJR Am J Roentgenol 166:635–639PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Se Hyung Kim
    • 1
  • Jeong Min Lee
    • 1
    • 2
    • 7
    Email author
  • Joon Koo Han
    • 1
    • 2
  • Jae Young Lee
    • 1
  • Won Joon Kang
    • 3
  • Jin Young Jang
    • 4
  • Kyung-Sook Shin
    • 5
  • Kyunghee C. Cho
    • 6
  • Byung Ihn Choi
    • 1
    • 2
  1. 1.Department of RadiologySeoul National University HospitalSeoulSouth Korea
  2. 2.Institute of Radiation MedicineSeoul National University HospitalSeoulSouth Korea
  3. 3.Department of Nuclear MedicineSeoul National University HospitalSeoulSouth Korea
  4. 4.Department of SurgerySeoul National University HospitalSeoulSouth Korea
  5. 5.Chungnam National University HospitalTaejeonSouth Korea
  6. 6.New Jersey Medical SchoolNewarkUSA
  7. 7.Department of RadiologySeoul National University College of MedicineSeoulSouth Korea

Personalised recommendations