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Figure 21. 30-year-old woman with Wegener's granulomatosis. (a) An ultrasound image of the spleen shows peripheral low echogenicity (arrow). (b) A colour Doppler image of the spleen in the same patient showing a normal central perfusion. (c) Following administration of 2.4 ml intravenous Sonovue (Bracco, Italy) microbubble contrast imaging was performed in a low MI (mechanical index) contrast pulse sequence mode (CPS; Acuson-Siemens, USA). The left hand image shows microbubble-specific imaging demonstrating perfusion of the central portion of the spleen with sparing of the subcapsular region (arrow). The right hand image depicts the corresponding B mode, once again showing peripheral low echogenicity (arrow). Appearances are consistent with subcapsular infarction secondary to vasculitis.
