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Zufallsbefunde in der Abdomensonographie

Charakteristika und klinische Interpretation

Incidental findings in abdominal ultrasound

Characteristics and clinical interpretation

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Zusammenfassung

Die Abdomensonographie stellt ein Standarddiagnostikum in der Inneren Medizin dar. Die korrekte Einschätzung von Zufallsbefunden bereitet in der Praxis oft Schwierigkeiten und führt häufig zu aufwendigen und kostenintensiven Folgeuntersuchungen, teilweise sogar zu unnötigen invasiven Maßnahmen wie Punktionen. Daher ist die Kenntnis von Zufallsbefunden in der Abdomensonographie von größter klinischer und ökonomischer Bedeutung. Häufig sind die erhobenen Befunde harmlos, bedürfen jedoch einer korrekten Diagnose und Dignitätseinschätzung für das weitere klinische Management. Neben der routinemäßigen B-Bild-Sonographie finden die Farbdopplersonographie und die kontrastunterstützte Sonographie breite Anwendung. Diese Verfahren erlauben häufig die differenzialdiagnostische Zuordnung der Befunde. Im Folgenden werden häufige Zufallsbefunde an den großen Organen und Gefäßen des Bauchraums vorgestellt. Die differenzialdiagnostischen Abläufe und Entscheidungskriterien, die zu einer korrekten Diagnose führen, werden erläutert.

Abstract

Abdominal ultrasound is a common diagnostic procedure in internal medicine. The correct interpretation of incidental findings can be difficult at times and often results in expensive and sometimes invasive follow-up examinations. Therefore, detailed knowledge of incidental findings on abdominal ultrasound is of utmost clinical and economical importance. Incidental findings are often benign, however, an accurate evaluation and correct diagnosis is crucial for the subsequent clinical management. To this end B-mode ultrasonography is complemented by color flow Doppler sonography and contrast-enhanced ultrasonography to add dynamic information on blood flow and vessel formation. This article presents frequent incidental findings of the major abdominal organs and vessels, and describes the sonographic and clinical management to find the correct diagnosis.

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Danksagung

Die Autoren bedanken sich bei Dr. Wilhelm Nimphius und Prof. Dr. Roland Moll, Institut für Pathologie, für die Bereitstellung der immunhistochemischen Färbung des Leberzelladenoms. Die Autoren bedanken sich bei PD Dr. Karlheinz Seitz und Frau Prof. Strobel für die kritische Durchsicht und Überarbeitung des Manuskripts.

Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Görg, S. Kunsch und A. Neesse geben an, dass kein Interessenkonflikt besteht. C. Görg hat Vortragshonorare der Firma Bracco Imaging erhalten. Bracco Imaging hat zudem Workshops für Kontrastmittelsonographie an der Universität Marburg unterstützt. A. Neesse erhält Forschungsgelder im Rahmen einer Max-Eder-Nachwuchsgruppe der Deutschen Krebshilfe. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Hämatologie, Onkologie und Immunologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstr., 35043, Marburg, Deutschland

    C. Görg

  2. Klinik für Gastroenterologie II, Universitätsmedizin Göttingen, Göttingen, Deutschland

    S. Kunsch & A. Neesse

  3. Klinik für Gastroenterologie, Endokrinologie, Infektiologie und Stoffwechsel, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Marburg, Deutschland

    A. Neesse

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  1. C. Görg
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  2. S. Kunsch
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  3. A. Neesse
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Correspondence to C. Görg.

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Görg, C., Kunsch, S. & Neesse, A. Zufallsbefunde in der Abdomensonographie. Internist 55, 998–1018 (2014). https://doi.org/10.1007/s00108-014-3454-5

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