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Characterization of indeterminate spleen lesions in primary CT after blunt abdominal trauma: potential role of MR imaging

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Abstract

The purpose of this study was to determine the value of magnetic resonance imaging (MRI) for characterization of indeterminate spleen lesions in primary computed tomography (CT) of patients with blunt abdominal trauma. Twenty-five consecutive patients (8 female, 17 male, mean age 51.6 ± 22.4 years) with an indeterminate spleen lesion diagnosed at CT after blunt abdominal trauma underwent MRI with T2- and T1-weighted images pre- and post-contrast material administration. MRI studies were reviewed by two radiologists. Age, gender, injury mechanism, injury severity score (ISS), management of patients, time interval between CT and MRI, and length of hospital stay were included into the analysis. Patient history, clinical history, imaging, and 2-month clinical outcome including review of medical records and telephone interviews served as reference standard. From the 25 indeterminate spleen lesions in CT, 11 (44 %) were traumatic; nine (36 %) were non-traumatic (pseudocysts, n = 5; hemangioma, n = 4) and five proven to represent artifacts in CT. The ISS (P < 0.001) and the length of hospital stay (P = 0.03) were significantly higher in patients with spleen lesions as compared with those without. All other parameters were similar among groups (all, P > 0.05). The MRI features ill-defined lesion borders, variable signal intensity on T1- and T2-weighted images depending on the age of the hematoma, focal contrast enhancement indicating traumatic pseudoaneurysm, perilesional contrast enhancement, and edema were most indicative for traumatic spleen lesions. As compared with CT (2/25), MRI (5/25) better depicted thin subcapsular hematomas as indicator of traumatic spleen injury. In conclusion, MRI shows value for characterizing indeterminate spleen lesions in primary CT after blunt abdominal trauma.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Sonja Gordic & Hatem Alkadhi

  2. Clinic of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland

    Hans-Peter Simmen, Guido Wanner & Dieter Cadosch

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  1. Sonja Gordic
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  2. Hatem Alkadhi
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  3. Hans-Peter Simmen
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  4. Guido Wanner
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  5. Dieter Cadosch
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Correspondence to Hatem Alkadhi.

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Gordic, S., Alkadhi, H., Simmen, HP. et al. Characterization of indeterminate spleen lesions in primary CT after blunt abdominal trauma: potential role of MR imaging. Emerg Radiol 21, 491–498 (2014). https://doi.org/10.1007/s10140-014-1227-z

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  • DOI: https://doi.org/10.1007/s10140-014-1227-z

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