Zusammenfassung
Die Bildgebung stellt ein zentrales Element der Diagnostik und zwischenzeitlich auch der Therapieerfolgskontrolle in der Rheumatologie dar. Neben der langjährig bewährten Röntgendiagnostik und der Gelenk- und Weichteilsonographie bietet insbesondere die Magnetresonanztomographie (MRT) die Möglichkeit einer 3-dimensionalen Darstellung von Muskulatur, Sehnen, Bändern, Kapsel, Synovialis und Knochen in hoch auflösender Qualität. In der Frühdiagnostik entzündlicher Gelenk- oder Wirbelsäulenveränderungen hat sich die MRT in den vergangenen Jahren etablieren können. Kontrastmittelunterstützte Untersuchungen ermöglichen eine Beurteilung der Krankheitsaktivität und eine Unterscheidung zwischen aktiven und chronisch-entzündlichen Veränderungen. Die MRT-Untersuchungen sind weitgehend standardisiert und reproduzierbar. Damit können der Krankheitsverlauf des Patienten dokumentiert und notwendige Therapieentscheidungen getroffen werden. Neben Mittel- (>0,5<1,0 T) und Hochfeldsystemen (>1,0 T) stehen für den Einsatz in der Rheumatologie auch patientenfreundliche Niederfeldsysteme (<0,5 T) zur Verfügung.
Abstract
Imaging plays a major role in the diagnosis and meanwhile also in the therapy control of rheumatic diseases. Besides the commonly used X-ray technique and musculoskeletal ultrasound, magnetic resonance imaging (MRI) is able to provide a three-dimensional view of musculature, ligaments, tendons, capsules, synovial membranes, bones and cartilage with high resolution quality. Therefore, MRI is being employed more and more in the early diagnosis of inflammatory joint and spinal diseases. Contrast-enhanced MRI enables an assessment of disease activity and a differentiation between active and chronic joint manifestation. The technical examinations by MRI are these days standardized and invariably reproducible. This makes it possible to document the course of a disease and allows subsequent treatment decisions. In addition to midfield (>0.5<1.0 T) and high field MRI (>1.0 T), low field MRI (<0.5 T) is used in rheumatology as a patient-friendly office-based technique.
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Kellner, H., Kellner, W. Magnetresonanztomographie in der Rheumatologie. Z. Rheumatol. 70, 493–506 (2011). https://doi.org/10.1007/s00393-011-0833-3
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DOI: https://doi.org/10.1007/s00393-011-0833-3
Schlüsselwörter
- Rheumatoide Arthritis
- Seronegative Spondylarthropathien
- Frühdiagnostik
- Magnetresonanztomographie
- Bildgebung