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Bildgebung des Lungenemphysems

Imaging of emphysema

Der Radiologe volume 47, pages 401–406 (2007)Cite this article

Zusammenfassung

Das Lungenemphysem, histologisch definiert als eine abnorme permanente Erweiterung der Lufträume distal der terminalen Bronchiolen, begleitet von Destruktionen der Alveolarwände und ohne Zeichen einer wesentlichen Fibrose, ist eine überaus häufige Erkrankung mit hoher Mortalität und Morbidität. Dem typischerweise beim angeborenen α1-Antitrypsinmangel angetroffenen panlobulären Emphysem steht das häufigere durch Zigarettenrauchen induzierte zentrilobuläre Emphysem gegenüber. Die Computertomographie (CT) weist im Gegensatz zum konventionellen Röntgen und zu den Lungenfunktionstests eine hohe Sensitivität für die Detektion des Emphysems auf, ermöglicht eine Bestimmung des Schweregrads, eine Quantifizierung der emphysematösen Veränderungen und weist assoziierte Veränderungen und Komplikationen nach. Das bildgebend durch das Fehlen klar definierter Ränder gekennzeichnete Emphysem ist differenzialdiagnostisch von zystischen Lungenerkrankungen, Bullae, Lungenlazerationen, der Langerhans-Zell-Histiozytose und Lymphangioleiomyomatose abzugrenzen, die computertomographisch eine Wandbegrenzung zeigen.

Abstract

Emphysema is defined as a condition of the lung characterized by abnormal, permanent enlargement of airspaces distal to the terminal bronchiole accompanied by destruction of the alveolar walls and without obvious fibrosis. It is a very common disease with high morbidity and mortality. Histopathologically, there are two types of emphysema: panlobular emphysema, typically occurring in α1-antitrypsin deficiency, and centrilobular emphysema, which is strongly associated with cigarette smoking. Computed tomography (CT) allows detection of emphysema with higher sensitivity than conventional chest radiography and pulmonary function tests. CT also allows quantification of emphysema and depicts associated changes and complications. The differential diagnosis of emphysema, which is characterized by the absence of clearly definable walls on CT, includes cystic lung disease, bullae, lung laceration, Langerhans cell histiocytosis, and lymphangioleiomyomatosis –which are all characterized by visible walls on CT.

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  1. Institut für Radiodiagnostik, Medizinische Universität, Währinger Gürtel 18-20, A-1090, Wien, Österreich

    C. Grosse & A. Bankier

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Grosse, C., Bankier, A. Bildgebung des Lungenemphysems. Radiologe 47, 401–406 (2007). https://doi.org/10.1007/s00117-006-1459-3

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