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Pulmonalarterielle und pulmonalvenöse Drucksteigerung

Increased pulmonary arterial and venous pressure

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Zusammenfassung

Hintergrund

Drucksteigerungen in den Pulmonalarterien und Pulmonalvenen haben vielfältige Ursachen. Nichtinvasive Bildgebung spielt nicht nur bei der Erkennung, sondern auch bei der differenzialdiagnostischen Einordnung eine wichtige Rolle.

Fragestellung

Dieser Artikel gibt einen vergleichenden Überblick über die Bildbefunde bei pulmonalarterieller und pulmonalvenöser Drucksteigerung im Röntgen-Thorax und in der Computertomographie (CT).

Radiologische Verfahren

Typische Zeichen einer pulmonalarteriellen und pulmonalvenösen Drucksteigerung im Röntgen-Thorax und in der CT erleichtern die Diagnose einer pulmonalen Hypertonie (z. B. Erweiterung der zentralen Lungenarterien) bzw. eines interstitiellen oder eines alveolären Lungenödems (z. B. Kerley-Linien/verdickte Interlobulärsepten oder Schmetterlingsödem). Ein grundlegendes Verständnis der einzelnen Bildbefunde und der zugrunde liegenden Pathophysiologie ist bei der differenzialdiagnostischen Einordnung hilfreich.

Schlussfolgerung

Röntgen und CT-Thorax sind für die Diagnostik bei Patienten mit vermuteter pulmonalarterieller oder pulmonalvenöser Drucksteigerung unverzichtbar.

Abstract

Background

Increases in pressure in the pulmonary arteries or pulmonary veins may be the result of a variety of underlying diseases. Noninvasive imaging plays a crucial role not only for identification, but also for differential diagnosis.

Objectives

This article provides a comparative review of the signs of increased pulmonary arterial and pulmonary venous pressure in chest X‑ray and computed tomography (CT).

Radiological procedures

Typical signs of a pulmonary arterial or pulmonary venous pressure increase in chest X‑ray and CT facilitate diagnosis of pulmonary hypertension (e.g., enlargement of central pulmonary arteries) and interstitial or alveolar pulmonary edema (e.g., Kerley lines/thickened interlobular septae or butterfly edema). A basic understanding of imaging findings and underlying pathophysiology helps in establishing the differential diagnosis.

Conclusions

Chest X‑ray and CT are essential for diagnosis of patients with suspected increased pulmonary arterial or pulmonary venous pressure.

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Authors and Affiliations

  1. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland

    Claudius Melzig MD &  Fabian Rengier MD

  2. Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland

    Claudius Melzig MD &  Fabian Rengier MD

Authors
  1. Claudius Melzig MD
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  2. Fabian Rengier MD
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Correspondence to Fabian Rengier MD.

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Interessenkonflikt

C. Melzig und F. Rengier geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Melzig, C., Rengier, F. Pulmonalarterielle und pulmonalvenöse Drucksteigerung. Radiologe 62, 120–129 (2022). https://doi.org/10.1007/s00117-021-00951-y

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