ROENTGEN VISUALIZATION OF THE SPLEEN A METHOD USEFUL TO CLINICAL DIAGNOSIS

Abstract

A routinely applicable method of roentgen visualization of the spleen is described, which is useful to diagnose the enlarged but not parpable spleen.
Technique: The patient is given one-half to one effervescent powdor before meal. Then the P. A. and left oblique views are taken in prone position, using a Potter-Bucky diaphragm. The films are exposed at 40 inch distance, one to one-half second, 100-120ma., 65-75kv.
The measurements of the spleen shadow are illustrated in Fig. 4. The criteria for determining splenic enlargement are as follows.
1) The spleen is not enlarged if the “T” is less than 5cm and the “W” is less than l0cm.
2) The spleen is doubtfully enlarged if the “T” is from 5 to 6cm or the “W” is from 10 to 12cm.
3) The spleen is probably enlarged if the “T” is more than 6cm or the “W” is more than 12cm or the “D” is more than 1.5cm.
4) The spleen is definitly enlarged if the “T” and the “W” are more than 6cm and 12cm respectively, while the “D” is more than 1.5cm.
The other signs of enlarged spleen which can decide the diagnosis in questionable cases are:
The upper pole of the spleen reaches to the top of the diaphragm, and the shape of stomach-bubble is cylindrical or oblonged.
The following should be added:
1) In the cases of greatly enlarged spleen, its size and shape are recorded by the roentgenogram in spine position with no contrast technique.
2) Tomographic studies of 15 normal subjects show that the angle of normal splenic axis (A. A. in Table 3.) to the transverse plane in prone position is 8 degrees upward to 26 degrees downward, and far less than that of the direction of the 10th. rib (A. R.).