Spleen visualization

Technetium-99m albumin coUoid is cleared by the reticuloendothehal (RE) cells and is used for visualization of the RE system of the Hver, spleen, and bone marrow. The product is formed by the addition of up to 2.8 GBq (75 mCi) of Tc pertechnetate. 

Plasma protein binding of LSD is >80%. As the drug penetrates the CNS, it is concentrated in the visual brain areas and the limbic and reticular activating systems, correlating with perceived effects. LSD is also found in the liver, spleen, and lungs.5 The volume of distribution is reported to be low at 0.28 L/kg.1 Wagner et al.6 described a two-compartment open model for LSD with an elimination half-life of 3 h. 

Each laparoscopy should aim at a visual assessment of the spleen in terms of (7.) size, (2.) colour, (i.) shape, and (4.) identifiable spleen diseases. Special mention should be made of capsular fibrosis, hyalinosis ( sugar-coated spleen ), tumours (e. g. Hodgkin s disease, retothelial sarcoma), tuberculosis, splenic cysts, splenic infarction (s. fig. 35.10) and splenic haematoma. Given appropriate positioning, the spleen is visible in 80% of cases. In the case of myeloproliferative diseases, a biopsy of the spleen (e. g. by means of the Menghini technique) can provide a definitive diagnosis, (s. pp 135,253) (s. figs. 11.1 14.7) (see chapter 11)... 

Fig. 8.11 Arterioportography coeliacography with good visualization of the branches of the coeliac trunk including the fine ramifications. Small hypervascularized haemangioma ( ) S = spleen. (The pancreatic vessels are also visible.) Normal depiction of the portal vessels in the venous phase...

In animal experiments, a contrast medium was first injected percutaneously into the spleen by s. Abeatici et al. in 1951 in order to visualize the portal circulation by means of X-ray. This method was later introduced into clinical practice as direct splenoportography by XL. Leger (1951) and R. Boulvin et al. (1951). 

Direct splenoportography is the most informative procedure for visualizing the portal vein system and its collaterals, (s. p. 181) Yet this technique is costly, time-consuming and high-risk. The injection of contrast medium into the spleen is carried out either percu-taneously (sonography-gmded) or, preferably, by laparoscopy. It is also possible to measure the pressure in the portal vein system. In addition, this method ensures access to the collaterals if radiological obliteration is planned, (s. p. 181)... 

This technique reveals decreased uptake of the radioisotope with an irregular pattern. Regeneration nodes cannot be visualized. There is enhanced storage in the spleen and bone marrow, (s. fig. 9.1)... 

Radionuclide imaging is useful to visualize the liver, spleen, bile ducts, gallbladder, and gut. 

Figure 9 RT-PCR analysis of cytokine mRNA expression in the spleens of DBA/2 mice immunized with casein/CKA. Total RNA was extracted from pooled spleens of S DHA/2 mice or CVE-administercd mice 3 weeks after immunized using RNAzol and reverse-transcribed, and the cDNA concentration was adjusted by co-amplification of two fold serially diluted cDNA and constant amounts of control plasmid pMCQ with [5-actin specific primers. Cytokine expression patterns of IL-12, IFNy, IL-6, and 11.-10 were determined by PCR using murine cytokine-specific primers. The PCR products were separated in 2 % agarose gel and visualized by ethidium bromide staining. Relative quantification of the amounts of the RT-PCR products was performed using a Computing Densitometer and NIH Image software,...

After PSE, the spleen retains its ability to regenerate. KuMPEetal. [120] found substantial regeneration of splenic tissue in 9 of 11 patients despite 70%-80% embolization, as visualized on Tm-99m sulfur colloid liver-spleen scans performed 4 to 16 months later. In contrast, Watanabe et al. [128] reported that PSE of 80% or more resulted in initial increases in spleen size followed by substantial and stable reductions by 4 months. Despite these conflicting results, a repeat PSE procedure can be performed with similar effectiveness should symptoms recur [98]. 

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