Differential diagnosis of chronic splenomegaly by grey-scale ultrasonography: Clinical observations and digital A-scan analysis.

Hitherto, ultrasound examination of the spleen has been limited to the determination of size and position. Grey-scale ultrasonography involves enhanced signal-to-noise ratio so that the soft-tissue texture is displayed, and this permits the recognition of diffusely abnormal consistency. This facility was used to predict lymphomatous involvement of the spleen in patients coming to laparotomy in whom an accuracy of 77-8 per cent was achieved. Three types of splenic consistency are described in a series of 60 patients presenting with chronic splenomegaly: Very low-level echoes emanate from malignantly involved spleens. Medium-level echoes are found in various benign conditions and high-level echoes occur in various chronic inflammatory conditions. These differences were confirmed and quantitated by computerized A-scan analysis.