Management of Incidental Splenic Lesions on CT or MRI

*Cyst: imperceptible wall, near-water attenuation (<10 HU), no enhancement. †Hemangioma: discontinuous, peripheral, centripetal enhancement (findings that are uncommon in splenic hemangiomas). ‡Benign imaging features: homogeneous, low attenuation (<20 HU), no enhancement, smooth margins. §Evaluate: PET vs. MRI vs. biopsy. ∥Suspicious imaging features: heterogeneous, enhancement, irregular margins, necrosis, splenic parenchymal or vascular invasion, substantial enlargement. ¶Indeterminate imaging features: heterogeneous, intermediate attenuation (>20 HU), enhancement, smooth margins. #Follow-up MRI in 6 and 12 months.

 From: Heller, M. T., Harisinghani, M., Neitlich, J. D., Yeghiayan, P., & Berland, L. L. (2013). Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. Heller, M. T., Harisinghani, M., Neitlich, J. D., Yeghiayan, P., & Berland, L. L. (2013). Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. Journal of the American College of Radiology : JACR, 10(11), 833–839.