Aim: In this comparative study we determined whether the use of colour Doppler sonography (CDS) vs. B-mode ultrasound in the diagnosis of focal splenic lesions improves diagnostic accuracy. Using ultrasound scans of focal splenic lesions, diagnostic accuracy in relation to the level of sonographic experience of the examiner was also measured.
Method: Eight ultrasound examiners with different levels of sonographic experience were given clinical data and sonographic pictures (B-mode and CDS) of 63 patients in two separated sequences. After viewing the first sequence (B-mode), the examiners had to formulate a diagnosis which they could either confirm or change after viewing the second sequence (CDS).
Results: In the least experienced reviewer, diagnostic accuracy was 32 % in B-mode, compared to 35 % in CDS; the most experienced reviewer scored 72 % (B-mode) and 75 % (CDS). In none of the entities examined in this study the use of CDS resulted in a significant increase in diagnostic accuracy.
Conclusion: The contribution of CDS in the (differential) diagnosis of focal splenic lesions is not significant. In routine ultrasound examination of the spleen, CDS is not necessary. Only with some very specific diagnostic questions CDS supplies a fast and reliable diagnosis. In focal splenic lesions, diagnostic accuracy of either B-mode and CDS is higher with experienced examiners.