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Ultraschall bei Riesenzellarteritis

  • M. Aschwanden
  • S. Imfeld
  • W. Schäberle
  • D. Staub
  • T. Daikeler
Vaskuläre Sonographie
  • 54 Downloads

Zusammenfassung

Hintergrund und Fragestellung

Über die letzten Jahre hat die Wichtigkeit der Bildgebung bei der Frage nach Vorliegen einer Großgefäßvaskulitis massiv zugenommen. Der Ultraschall hat trotz gewisser Limitationen (z. B. fehlende Beurteilbarkeit der thorakalen Aorta) dank der raschen Verfügbarkeit, fehlender Strahlenbelastung, aber auch wegen seiner im Vergleich geringen Kosten einen nicht mehr wegzudenkenden Platz im Abklärungsalgorithmus.

Methode

Es sollen die Validität, aber auch potenzielle Fallstricke bei der Ultraschalluntersuchung anhand der Literatur aufgezeigt werden.

Ergebnisse und Schlussfolgerungen

Die „konventionelle“ Form der Gefäßultraschallabklärung mit B‑Bild, Farb- und gepulstem Doppler hat einen sehr hohen Stellenwert in der Abklärung der Großgefäßvaskulitis. Die Summe ihrer Vorteile hat dazu geführt, dass sie in immer mehr aufkommenden „fast track clinics“ in der Erstabklärung, fokal angewendet, zum Standard gehört. Der kontrastmittelunterstützte Ultraschall birgt das Potenzial einer hilfreichen Ergänzung in der initialen Beurteilung, aber auch im Verlauf bei Frage nach Rezidiv zu werden.

Schlüsselwörter

Ultraschall Großgefäßvaskulitis Riesenzellarteritis Diagnostik 

Ultrasound in giant cell arteritis

Abstract

Background

Over the last few years, the importance of imaging methods in the suspected presence of large vessel vasculitis has increased massively. Despite certain limitations (e. g., lack of assessability of the thoracic aorta), ultrasound has become an indispensable part of the diagnostic algorithm owing to its fast availability, lack of radiation exposure, but also because of its comparatively low costs.

Methods

The validity, but also potential pitfalls of ultrasound examinations are shown based on the literature.

Results and conclusions

The “conventional” type of vascular ultrasound imaging by B‑scan, color, and pulsed Doppler has great significance in the diagnostic work-up of large vessel vasculitis. All its advantages have led to focused ultrasound being introduced as standard imaging for first diagnosis into increasing numbers of emerging “fast track clinics.” Contrast-enhanced ultrasound has the potential to become a helpful adjunct not only in the initial assessment, but also in the follow-up of suspected recurrence.

Keywords

Ultrasound Large vessel vasculitis Giant cell arteritis Diagnosis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Aschwanden, S. Imfeld, W. Schäberle, D. Staub und T. Daikeler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • M. Aschwanden
    • 1
  • S. Imfeld
    • 1
  • W. Schäberle
    • 3
  • D. Staub
    • 1
  • T. Daikeler
    • 2
  1. 1.Abteilung für AngiologieUniversitätsspital BaselBaselSchweiz
  2. 2.Abteilung für RheumatologieUniversitätsspital BaselBaselSchweiz
  3. 3.Klinik für Viszeral‑, Gefäß‑, Thorax- und KinderchirurgieKlinik am EichertGöppingenDeutschland

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