Journal of Medical Ultrasonics

, Volume 45, Issue 3, pp 515–523 | Cite as

Superb microvascular imaging (SMI) findings of splenic artery pseudoaneurysm: a report of two cases

  • Yumiko YamanakaEmail author
  • Hideaki Ishida
  • Hiroko Naganuma
  • Tomoya Komatsuda
  • Hideaki Miyazawa
  • Takaharu Miyauchi
  • Satoshi Takahashi
  • Tomoki Tozawa
  • Katsuhiko Enomoto
Case Report


Splenic artery pseudoaneurysm (SAPA) is a relatively infrequently encountered but clinically important vascular change, because it carries a high risk of rupture that warrants prompt treatment regardless of its size. Thus, sufficient knowledge is indispensable when seeing chronic pancreatitis patients or post-traumatic patients. Here, we report two such cases. The first case was a 52-year-old woman known to have chronic pancreatitis who presented with hematemesis and hemodynamic instability in which X-ray computed tomography (CT) and color Doppler sonography (CDS) had difficulty visualizing slow blood flow in SAPA, but superb microvascular imaging (SMI) clearly demonstrated the slow blood flow in SAPA, prompting our therapeutic decision to perform rapid embolization. The second case was a 51-year-old woman with post-traumatic SAPA in which 3D SMI enabled us to understand more clearly the topographic relationship between multiple SAPAs as compared with conventional US, leading to a decision to provide immediate surgical treatment. SMI was thought to provide a new insight into the US diagnosis of SAPA. When examining patients suspected of having a SAPA, SMI is an indispensable diagnostic tool at present.


Ultrasound Pancreas Spleen Pancreatitis Pseudoaneurysm Superb microvascular imaging (SMI) 



Splenic artery peudoaneurysm


X-ray computed tomography


Color Doppler sonography


Superb microvascular imaging


Contrast-enhanced ultrasonography








Compliance with ethical standards

Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Conflict of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© The Japan Society of Ultrasonics in Medicine 2018

Authors and Affiliations

  • Yumiko Yamanaka
    • 1
    Email author
  • Hideaki Ishida
    • 1
  • Hiroko Naganuma
    • 2
  • Tomoya Komatsuda
    • 1
  • Hideaki Miyazawa
    • 3
  • Takaharu Miyauchi
    • 4
  • Satoshi Takahashi
    • 5
  • Tomoki Tozawa
    • 5
  • Katsuhiko Enomoto
    • 6
  1. 1.Center of Diagnostic UltrasoundAkita Red Cross HospitalAkitaJapan
  2. 2.Department of GastroenterologyYokote Municipal HospitalYokoteJapan
  3. 3.Department of Gastrointestinal SurgeryAkita Red Cross HospitalAkitaJapan
  4. 4.Department of RadiologyAkita Red Cross HospitalAkitaJapan
  5. 5.Department of Diagnostic RadiologyAkita University HospitalAkitaJapan
  6. 6.Department of Diagnostic PathologyAkita Red Cross HospitalAkitaJapan

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