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Diffuse und vaskuläre Lebererkrankungen

Diffuse and vascular hepatic diseases

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Zusammenfassung

Neben den fokalen Leberläsionen stellen diffuse und vaskuläre Lebererkrankungen ein weites Spektrum an Erkrankungen der Leber dar, die radiologisch oft schwer oder gar nicht diagnostizierbar sind. Klassische diagnostische Verfahren sind dabei neben dem Ultraschall die Computertomographie und die Magnetresonanztomographie.

Diffuse Parenchymschäden, bedingt durch Erkrankungen unterschiedlichster Ätiologie, sind deshalb schwierig evaluierbar, weil häufig charakteristische bildmorphologische Merkmale fehlen. Die Steatosis hepatis, die Hämochromatose/Siderose als Beispiel der Speicherkrankheiten sowie die Sarkoidose und die Candidose als infektiös-entzündliche Erkrankungen sind einer bildbasierten Diagnosestellung z. T. zugänglich, bei den meisten diffusen Lebererkrankungen jedoch zeigen sich lediglich unspezifische Veränderungen. Vaskuläre Pathologien der Leber wie das Budd-Chiari-Syndrom und die Pfortaderthrombose sind dagegen in der Regel radiologisch eindeutig diagnostizierbar und z. T. auch interventionell gut behandelbar. Chronische Verläufe gehend fließend in eine Leberzirrhose über, die mit einem erhöhten Karzinomrisiko vergesellschaftet ist.

Abstract

In addition to focal liver lesions, diffuse and vascular disorders of the liver represent a wide spectrum of liver diseases which are from the radiological point of view often difficult or nearly impossible to diagnose. Classical diagnostic methods are computed tomography and magnetic resonance imaging in addition to ultrasound.

Diffuse parenchymal damage caused by diseases of various etiologies is therefore difficult to evaluate because it often lacks characteristic morphological features. For hepatic steatosis, hemochromatosis/siderosis as an example of a diffuse storage disease and sarcoidosis and candidiasis as infectious/inflammatory diseases, an image-based diagnosis is appropriate in some cases. For most diffuse liver diseases, however only nonspecific changes are visualized. Vascular pathologies of the liver, such as the Budd-Chiari syndrome and portal vein thrombosis, however, can usually be diagnosed very clearly using radiology and there is also a very effective interventional radiological treatment. Chronic diseases very often culminate in liver cirrhosis which is highly associated with an increased risk of liver cancer.

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  1. Abteilung Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    S. Kreimeyer & L. Grenacher

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  1. S. Kreimeyer
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  2. L. Grenacher
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Correspondence to S. Kreimeyer.

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Kreimeyer, S., Grenacher, L. Diffuse und vaskuläre Lebererkrankungen. Radiologe 51, 704–713 (2011). https://doi.org/10.1007/s00117-010-2129-z

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