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Der diagnostische Stellenwert der Mehrschichtcomputertomographie (MSCT) bei thorakalen und abdominellen Notfällen

Diagnostic value of multislice computed tomography for thoracic and abdominal emergencies

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Zusammenfassung

Seit der Einführung der Mehrschichtcomputertomographie (MSCT) und aufgrund der immer besseren Verfügbarkeit spielt diese Technik auch in der Notfalldiagnostik eine wichtige Rolle. Mit modernen Computertomographen können in wenigen Sekunden umfassende Datensätze großer Körpervolumina, bis hin zu Ganzkörper-Untersuchungen bei polytraumatisierten Patienten, erfasst werden. Aus den gewonnen Daten können neben den axialen Schnittbildern auch Aufnahmen wie multiplanare Rekonstruktionen (MPR) und Volumendarstellungen (VR) rekonstruiert werden, die innerhalb kürzester Zeit zur Befundung bereitstehen. Auch in der Abklärung nichttraumatisch bedingter thorakaler oder abdomineller Schmerzen hat die MSCT einen zunehmenden Stellenwert für eine Vielzahl von Indikationen. Sie hat heute bereits teilweise weniger sensitive Verfahren, wie Röntgenuntersuchungen oder den Ultraschall, bzw. invasivere Verfahren, wie die Angiographie, abgelöst. Der vorliegende Beitrag beschreibt den Stellenwert der MSCT in der Notfalldiagnostik anhand wichtiger Krankheitsbilder und gibt einen Einblick in Indikationsstellung und verschiedene MSCT-Untersuchungsprotokolle.

Abstract

Since the introduction of multislice computed tomography (MSCT) this technique plays an important role in emergency radiology. With modern MSCT scanners datasets of large body volumes and even whole body examinations of polytrauma patients can be recorded within a few seconds. In addition to axial images multiplanar reconstructions (MPR) and volume-rendering imaging (VR) can be derived from this data and are rapidly available for analysis. Furthermore, MSCT is becoming of increasing importance in the diagnosis of non-traumatic abdominal or chest pains and has to some extent replaced less sensitive modalities, such as radiography and ultrasound or more invasive examination techniques such as catheter angiography. This article describes the role of MSCT in emergency diagnosis exemplified by important symptoms and gives an insight into the indications and various MSCT examination protocols.

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  1. Institut für Klinische Radiologie, Ludwig-Maximilians-Universität, Nussbaumstr. 20, 80336, München, Deutschland

    C. Degenhart

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Degenhart, C. Der diagnostische Stellenwert der Mehrschichtcomputertomographie (MSCT) bei thorakalen und abdominellen Notfällen. Notfall Rettungsmed 13, 451–457 (2010). https://doi.org/10.1007/s10049-010-1301-3

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