Your spleen is a small, soft, oval-shaped abdominal organ sitting underneath your left rib cage, just behind and above your stomach1. In adults, a normal spleen is between two and a half to seven ounces in weight and about the size of a fist2.
As part of your body’s lymphatic system, the spleen plays a vital role in keeping you healthy — from helping you fight off infection to getting rid of cellular waste3. Like with all other organs of the body, problems with the spleen can occur, ranging from splenic cysts to unusual enlargement.
Treatment usually depends on the suspected cause. Diagnosis often involves a series of tests, including Magnetic Resonance Imaging (MRI) of the spleen4.
This article reviews everything you need to know about an MRI of the spleen, why you might need one, and how to prepare for it. You’ll also learn about the average costs and why your routine healthcare tests should include a preventative scan of your spleen.
What Is an MRI of the Spleen?
An MRI of the spleen is a safe and painless procedure that uses strong radio waves and magnetic fields to capture detailed images of your spleen.
A radiology technician performs an MRI of the spleen as a preventative health screening procedure, and a radiologist reviews the results.
An MRI of the spleen may detect cysts and tumors and spot other anomalies5. It can also help monitor blood flow through the spleen and potentially discover splenic infarction, which occurs when blood flow to the spleen is compromised6.
Why Would You Have an MRI on Your Spleen?
Computed tomography (CT) and ultrasound imaging are the standard diagnostic procedures for evaluating the spleen7. An MRI of the spleen may also help validate initial CT findings.
An MRI of the spleen could be ordered for several reasons8:
- To investigate discomfort or pain in the lower left chest or left upper quadrant of the abdomen.
- To follow up on the detection of an enlarged spleen during a physical examination.
- To evaluate symptoms such as feeling full very quickly after meals, unexplained bleeding or bruising, frequent infections, and fatigue with anemia.
- To detect and identify splenic abnormalities, including splenomegaly (enlarged spleen), hypersplenism (overactive spleen), or ruptured or damaged spleen.
- To validate initial findings from other imaging techniques like CT scans or ultrasounds9.
- To diagnose and assess other spleen conditions.
- To evaluate the spleen in cases of suspected infectious diseases, blood disorders, or systemic conditions that may affect splenic function.
Understanding What Your Spleen Does Before Scheduling an MRI
Before planning an MRI, whether as part of your annual health screening or a diagnostic procedure recommended by your healthcare provider, it pays to understand the spleen’s role in overall health.
The spleen, alongside your lymph nodes, makes up the lymphatic network. The lymphatic network is a part of the immune system10.
This small but mighty abdominal organ is often hard at work. Its most important functions include11:
- Filtering blood and keeping it free from cellular waste
- Helping fight infection by producing white blood cells and other antibodies
- Helping maintain fluid balance in the body
- Helping reduce inflammation and assisting with wound healing
- Storing red blood cells and platelets
Your spleen has two types of splenic parenchyma, or splenic tissue: red pulp and white pulp12.
The red pulp is rich with blood vessels and filters old or damaged red blood cells. The white pulp, which is found inside the red pulp, is made of tiny lumps of lymphoid tissue and is responsible for producing antibodies.
What Are The Signs of Problems In The Spleen?
Signs of spleen problems include13:
- Pain or discomfort in the upper left abdomen which may spread to the left shoulder.
- Feeling full quickly after eating small amounts.
- Fatigue and weakness, possibly due to anemia.
- Increased susceptibility to infections.
- Easy bruising or bleeding.
- Enlarged abdomen or visible swelling under the left ribcage.
- Tenderness when touching the upper left abdomen.
In severe cases, such as in ruptured spleen, additional symptoms may include14:
- Severe abdominal pain.
- Dizziness due to low blood pressure.
- Confusion or fainting.
If you experience persistent abdominal pain or any combination of these symptoms, seek medical attention promptly.
What Can an MRI of the Spleen Tell You?
An MRI of the spleen can help spot and identify splenic abnormalities such as
- Splenomegaly
- Hypersplenism
- Ruptured or damaged spleen
Splenomegaly
An enlarged spleen can be painful and uncomfortable, especially right after a meal.
Your spleen can swell and become enlarged for a variety of reasons, including15:
- Certain types of anemia
- Blood cancers such as Hodgkin’s disease, leukemia, lymphoma, or when cancer that started in another organ has spread to the spleen (also known as splenic metastases)
- Development of blood clots in the liver or spleen
- Inflammatory conditions, including sarcoidosis, which is the development of clumps of inflammatory cells (granulomas) in other organs of the body
- Cystic fibrosis is a genetic condition where thick, sticky mucus tends to develop in the organs of the body
- Bacterial and viral infections such as glandular fever, syphilis, and malaria
An enlarged spleen can be life-threatening once it ruptures. It can also cause secondary infections, anemia, hemorrhage, or excessive bleeding.
In some cases, other diagnostic modalities, such as a bone marrow biopsy exam, are needed to determine the cause of splenomegaly.
Hypersplenism
An overactive spleen, also known as hypersplenism, destroys healthy blood cells16.
As a result, a person can become anemic, as the body doesn’t have the proper amount of oxygen. This can make it difficult to battle infections, as well.
In cases with severe, overactive spleen, splenectomy or surgical removal of the spleen may be necessary.
Hypersplenism can result from the following conditions:
- Chronic liver problems
- Infections
- Autoimmune conditions
- Certain types of cancer
In some cases, the cause of hypersplenism may be unknown.
Ruptured or Damaged Spleen
A splenic rupture or ruptured spleen can result from an enlarged, swollen spleen or a sudden blow to the left lower chest or left upper abdomen17.
It’s worth noting that a spleen can rupture hours or even weeks after trauma or injury.
Blood-related diseases, malaria, and infectious mononucleosis can also increase one’s risk of a ruptured spleen18,19.
What Can an MRI of the Spleen Show?
An MRI of the spleen may help reveal the following anomalies:
1. Accessory Spleen
Accessory spleen is a condition that is often present from birth. It describes small tissue of the spleen found separately from the main spleen organ.
While patients are usually asymptomatic, accessory spleen is estimated to occur in 10 to 30 percent of the population20.
2. Splenic Hematoma
Splenic hematoma is a condition that may occur as a result of blunt abdominal trauma or systemic diseases21.
3. Benign Tumors and Cysts
Splenic hemangiomas are rare splenic lesions but are one of the most common types of benign tumors with splenic involvement22. They may be discovered during MR imaging of the spleen.
A spleen MRI may additionally be able to detect other types of benign lesions in the spleen, including
- Splenic cysts, including pseudocysts (secondary), true cysts (primary), and splenic hydatid cysts23,24.
- Splenic lymphangioma is congenital in nature, meaning that something is either present at or from birth25.
- Splenic abscess, which may result from the presence of bacteria in the blood.
- Splenic hamartoma is often harmless but may cause pressure on surrounding tissues when it increases in size26.
4. Malignant Mass or Tumors
Splenic lymphoma is the most common type of splenic mass or tumor27.
Other malignant or cancerous lesions that an MRI of the spleen can reveal include the following:
- Angiosarcoma of the spleen is a rare but aggressive form of cancer that develops in the inner lining of lymph nodes and blood vessels in the spleen28.
- Splenic metastases when cancer cells from other organs spread to the spleen29. The most common cause of splenic metastasis is malignant melanoma, a type of skin cancer30.
- Malignant fibrous histiocytoma, also known as undifferentiated pleomorphic sarcoma31. As a rare type of cancer, it develops mainly in the body’s soft tissues. Soft tissues connect, support, and surround other body structures.
5. Splenic Vein Thrombosis
This condition develops when a clot partially or fully blocks the splenic vein, a blood vessel that drains blood away from the spleen and parts of the pancreas and stomach.
Splenic vein thrombosis occurs in 1 out of 5 patients with chronic pancreatitis (inflammation of the pancreas)32. It can also develop in patients with pancreatic cancer.
Most patients with this condition do not have symptoms, although portal hypertension can develop.
A CT scan, ultrasound, and MR imaging can help detect splenic vein thrombosis.
What Does a Normal Spleen MRI Look Like?
A normal spleen MRI shows a smooth, uniformly-colored organ in the upper left abdomen, just under the ribs. The spleen appears darker than the liver in some images and brighter in others, depending on the type of MRI scan used5.
When contrast dye is injected, the spleen initially shows a mottled pattern that quickly becomes even due to how blood flows through the spleen. The spleen should be a typical size without any unusual spots, lumps, or swelling. Blood vessels can be seen entering the spleen as dark lines.
What Does an Enlarged Spleen MRI Look Like?
An enlarged spleen on an MRI usually shows up as larger than normal size. It may extend below the ribcage and be visible in lower abdominal images4. The MRI might also show dilated blood vessels and possible compression of nearby organs due to the enlarged size.
MRI vs CT Scan for Spleen Imaging
Both MRI and CT scans are valuable imaging techniques for evaluating the spleen, with their own strengths and limitations4,7,9.
MRI Scan
- Provides superior soft tissue contrast
- Offers detailed visualization of splenic structure without radiation exposure.
- Effective at catching hemangioma.
- Takes longer than CT or ultrasound.
CT Scan
- Provides quick imaging with good spatial resolution.
- Contrast-enhanced CT enables excellent visualization of splenic trauma.
- Exposes patients to ionizing radiation.
Contrast Enhancement
Both modalities use contrast agents to enhance imaging:
- MRI uses gadolinium-based contrast, which is less likely to cause allergic reactions33.
- CT used iodine-based or barium-sulfate contrast agents.
Accuracy and Detection
Both MRI and CT are important for distinguishing malignant splenic lesions from benign ones9. MRI is more sensitive to detecting small lesions and characterizing tissue composition. CT is highly accurate at measuring spleen size and volume34.
How Much Does an MRI of the Spleen Cost?
Abdominal MRI, which includes the spleen, can range from $1,600 to $7,600 in the United States35.
If you’re uninsured or planning to have an elective MRI, you will likely pay out of pocket for your spleen MRI.
Preparing For an MRI of Your Spleen
The exact steps to take when preparing for an MRI of your spleen will depend on the procedure’s goal. It’s best to ask your doctor for instructions specific to your needs and condition.
You may be asked to fast for four hours before the examination, if possible, to aid in distinguishing abdominal anatomy. If contrast is required, you may also need to fast. However, if you have kidney or liver problems, you should inform your doctor, as it may affect the use of contrast agents.
Before the MRI: Leave all jewelry and metal objects at home. You can generally eat and drink normally unless instructed otherwise. If your MRI involves contrast agents or sedation, you may need to fast for a few hours beforehand.
You’ll be asked to change into a hospital gown and remove any clothing with metal components, including underwire bras. Inform your doctor about any medical conditions, implants, or claustrophobia, and bring a list of your current medications. Avoid using deodorants, perfumes, or lotions that may contain metals.
The procedure itself typically lasts about 30-60 minutes, requiring you to lie on a table that slides into the MRI machines. While there are loud noises involved, the radiologist is on hand to provide assistance and reassurance.
How to Find an MRI Center
Selecting an appropriate MRI provider is crucial for obtaining accurate results and high-quality care. Begin by consulting your physician to determine if an MRI is necessary and which type is most suitable for your specific needs. Your doctor can recommend reputable imaging centers and experienced radiologists based on your individual case.
When choosing an MRI provider, consider factors such as:
- Accreditation and certifications of the imaging center
- Qualifications and expertise of the radiologists
- Advanced technology and equipment available
- Convenience of location and scheduling options
- Cost and insurance coverage
Partnering with established imaging specialists and accredited facilities, like those associated with Ezra, can provide access to state-of-the-art technology and skilled radiologists. This ensures that you receive high-quality scans with expert interpretations, leading to more accurate and reliable results for your healthcare needs.
Taking Charge of Your Wellness
Ezra’s full-body screening is intended for patients looking to take charge of their wellness. The screening examines the spleen and up to 13 other organs in less than one hour.
This procedure is not intended for anyone currently experiencing symptoms or undergoing treatment for an existing condition.
If you feel ready to take charge of your health, you can book a scan today.
