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Diagnostische und interventionelle Abdomensonographie

Diagnostic and interventional abdominal ultrasonography

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Zusammenfassung

Die Abdomensonographie ist für den Internisten unverzichtbar. Im Gegensatz zu anderen bildgebenden Verfahren ist sie ein Schnittbildverfahren in Echtzeit, das nicht mit Strahlenbelastungen verbunden ist. Wie bei allen bildgebenden Verfahren ist neben der Verfügbarkeit hochqualitativer Ultraschallgeräte die Ausbildung des Untersuchers eine entscheidende Voraussetzung für die Qualität. Die Abdomensonographie ist den radiologischen Schnittbildverfahren bei vielen internistischen Fragestellungen zumindest ebenbürtig, z. B. bei chronisch-entzündlichen Darmerkrankungen, vaskulären Lebererkrankungen oder der Echtzeitüberwachung von Eingriffen. Durch die Verwendung von Echokontrastmitteln zur Detektion und Charakterisierung von Raumforderungen und Perfusionsstörungen innerhalb und außerhalb der Leber wurde der Anwendungsbereich der Sonographie nochmals deutlich erweitert.

Die minimal-invasive interventionelle Sonographie umfasst die Feinnadelpunktion oder Drainage von Raumforderungen und pathologischen Flüssigkeitsansammlungen. Darüber hinaus finden u. a. die ultraschallbasierte Tumortherapie sowie die Sklerosierung symptomatischer nichtparasitärer Zysten in Leber, Nieren und Milz Anwendung. Ein neues Feld wird mit der quantitativen reproduzierbaren Messung der Gewebesteife betreten. Die Fortentwicklung der mechanischen Elastographie verspricht zudem eine neue Form der Gewebecharakterisierung.

Abstract

Abdominal ultrasonography is an essential tool for physicians. In contrast to other imaging methods, ultrasound examination is a cost-effective real-time imaging method without radiation effects. As in all other imaging methods, abdominal ultrasound requires an experienced examiner and high quality equipment to maintain a high quality. Abdominal ultrasonography is at least equal to cross-sectional imaging methods in most clinical issues, e.g., in inflammatory bowel disease, vascular liver diseases, or real-time surveillance of interventions. The range of applications for ultrasound has been markedly expanded by using contrast-enhanced ultrasound to detect and characterize space occupying lesions or perfusion aberrations in- and outside the liver.

Ultrasound-guided fine needle aspiration biopsy or drainage of space occupying lesions and pathological liquids are minimally invasive standard ultrasound-guided interventions. Ultrasound-based tumor therapy as well as sclerotherapy of symptomatic nonparasitic cysts of the liver, kidneys, or spleen are also performed. By being able to provide quantitatively reproducible measurement of tissue stiffness, ultrasonography has entered a new era. The development of mechanical elastography also promises a new form of tissue characterization.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Die Autoren haben an Studien teilgenommen oder honorierte Vorträge gehalten für Siemens Healthcare AG (München), Toshiba Medical Systems (Neuss) sowie Zonare Medical Systems (Erlangen), und MSD (Haar).

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  1. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    A. Potthoff, M.J. Gebel & K. Rifai

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  1. A. Potthoff
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  2. M.J. Gebel
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  3. K. Rifai
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Correspondence to A. Potthoff.

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Potthoff, A., Gebel, M. & Rifai, K. Diagnostische und interventionelle Abdomensonographie. Internist 53, 261–270 (2012). https://doi.org/10.1007/s00108-011-2957-6

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