Zebra spleen

Dr Amir Rezaee et al.

Zebra spleen, also referred to as psychedelic spleen or more correctly inhomogeneous splenic enhancement refers to the transient heterogeneous parenchymal enhancement of the spleen during the arterial or early portal venous phases of contrast enhancement in CT, MRI, or ultrasound imaging.

It is due to the differing blood flow rates of blood (and contrast) between red pulp (which enhances early) and white pulp (which enhances later). Almost always, a portal venous or delayed phase study will show homogeneous attenuation throughout the spleen (in the absence of pathology).

There are 3 general patterns of enhancement 2:

  1. archiform: alternating bands of low and high density which may look like rings or zebra stripes
  2. focal: single area of low density
  3. diffuse: mottled appearance

Heterogeneity of splenic parenchyma manifested as alternating hypoechoic stripes can also be seen in non-contrast ultrasound examination of spleen with high-frequency linear transducer in children with no underlying splenic abnormalities; this has been assumed to be due to the difference in splenic parenchymal structures 2

Clinical importance

Inhomogeneous splenic enhancement can mimic:

Share article

Article Information

rID: 46039
Section: Signs
Tag: case
Synonyms or Alternate Spellings:
  • Zebra spleen
  • Zebra appearance to the spleen
  • inhomogeneous splenic enhancement
  • psychedelic spleen

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.