Spleen scanning is a nuclear study performed to assist in diagnosing abnormal structure or function of this organ. It is often performed to differentiate between splenomegaly and hepatomegaly, and it is performed in combination with liver scanning because the radionuclide is distributed in both organs at the same time (86 percent in the liver and 6 percent in the spleen). The radionuclide 99mTc administered as technetium Tc 99m sulfur colloid is injected IV, followed by scanning. The appearance or absence of "cold" defects or the appearance of multiple "cold" defects, resulting from the presence of the radionuclide on the images, determines splenic pathology.

• Normal size, length, perfusion, and function of the spleen; no infarction, hematoma, tumor, abscess, or cysts

• Inability of client to remain still during the procedure
• Barium in the gastrointestinal tract from prior radiography

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Indications

• Determining splenic arterial obstruction or pathological infiltration resulting from splenic inflammation or infarction as revealed by a marked decrease in radionuclide compared with liver intake
• Determining splenic involvement in diseases such as leukemia, lymphoma, or melanoma as revealed by splenic enlargement and focal changes
• Determining splenic rupture or hematoma after abdominal trauma as revealed by splenomegaly and diffuse diminished radionuclide uptake

Contraindications

• Pregnancy, unless the benefits of performing the procedure greatly outweigh the risks to the fetus

[Section Outline]

• Indications
• Contraindications

Nursing Care Before the Procedure

Client teaching and physical preparation are the same as those for the liver scan (see section under "Brain Scanning" and preceding "Liver Scanning" section).

The procedure is the same as for liver scanning (see preceding section). To obtain flow studies, imaging for 1 minute begins 30 minutes after injection of the radiopharmaceutical. Static imaging is performed to determine the size (anterior view), length (posterior view), and shape (lateral and anterior views) of the organ.

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any nuclear scan study (see section under "Brain Scanning").