The spleen is one of the most frequently affected organs in sickle cell anemia (SCA). This study\naims to characterize the spleen in sickle cell anemia patients using contrast enhanced computerized\ntomography scanning (CECT). 67 patients with SCA from different Saudi Arabian areas were\nenrolled; ages are ranged from 10 months to 28 years old. The spleen was assessed with CT for\nabdominal pain and/or unexplained fever. The evaluation was done at different contrast enhancement\nscanning phases. The study showed that the least number of affected patients was\nfrom Eastern Saudi Arabia (1.5%) followed by Asseer (16.4%) then Gazan representing 82.1%.\nThe most common type of SCA affected the Saudi children is Hemoglobin SS Disease (Hb SS) constituting\n41 (61.2%). The spleen size, lymph nodes size, spleen Hounsfield (HU), splenic vein diameter\nand the correlation with the associated findings were evaluated for all of the patients. In\nchildren affected with SCA: 26 (38.8%) have splenomegaly, 18 (26.9%) have atrophied spleen and\n2 (3.0%) are with very small tissue like structure. Lesions found in the spleen were abscess, infarction,\ncyst, and calcifications. At the spleen hilum region; dilated splenic vein, presence of multiple\ncollaterals, and thrombus were also been detected. Significantly correlations were noticed\nbetween lesions type, child age, enlargement of spleen and splenic lymph nodes at P 0.033, P \n0.010 and P 0.012 respectively and showed an evidence that the reduction of the HU and advanced\nage have significant relation with changing of the spleen size at P 0.004 and P \nrespectively. Spleen lesions� enhancement pattern is well emerged in both venous and delay phase\nand it was significantly related with the scanning phase at P 0.000 and with different types of\nSCA at P , and P 0.055 in venous and delay phase in respectively. CECT offers a number of\nmorphological criteria that can be applied to differentiate hypodense lesions of the spleen in SCA.\nCT characterization criteria of hypodense splenic lesions are acknowledged to aid interpretation\nduring evaluation of abdominal CT images of the spleen in symptomatic patients with sickle cell\nanemia.
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