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Sonographische Differenzialdiagnostik fokaler Leberläsionen

Ultrasound for the differential diagnosis of focal liver lesions

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Zusammenfassung

Für das klinische Management fokaler Leberläsionen ist eine rasche Dignitätseinschätzung und Diagnosestellung entscheidend. Neben der routinemäßigen B‑Bild-Sonographie finden die Farb-Doppler-Sonographie und die kontrastunterstützte Sonographie breite Anwendung in der Einordnung von Leberraumforderungen. Vor allem im Rahmen der Tumordetektion, in der Nachsorge onkologischer Patienten sowie der Früherkennung des hepatozellulären Karzinoms kommt der klinischen Sonographie eine wichtige Rolle in der Gastroenterologie zu. Für die korrekte Klassifizierung fokaler Leberläsionen ist dabei die Interpretation bildgebender Charakteristika im klinischen Kontext (z. B. Zufallsbefund, bekannte Risikofaktoren, Leberzirrhose oder Tumorerkrankung) essenziell. In dieser Übersicht werden die zur Charakterisierung von Leberläsionen zur Verfügung stehenden sonographischen Techniken zusammengefasst und ihre Bedeutung für die Differenzialdiagnose und das weitere diagnostische und therapeutische Management von Leberraumforderungen dargestellt.

Abstract

Rapid diagnostic assessment is crucial for the clinical management of focal liver lesions. In addition to standard B‑mode sonography, color-coded Doppler sonography and contrast-enhanced ultrasound are widely used for the classification of liver tumors. In gastroenterology, clinical sonography plays an important role in the detection of tumors, in the follow-up of oncological patients and for the screening for hepatocellular carcinoma. Thereby, correctly classifying focal liver lesions essentially requires the interpretation of ultrasound findings in the clinical context (e.g., incidental finding, known risk factors, history of liver cirrhosis or malignant disease). In this review, we summarize the available ultrasound techniques for the characterization of focal liver lesions and discuss their importance and relevance for the differential diagnosis and further diagnostic and therapeutic management.

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Authors and Affiliations

  1. Medizinische Klinik 1, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland

    Sebastian Zundler &  Deike Strobel

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  1. Sebastian Zundler
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  2. Deike Strobel
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Correspondence to Sebastian Zundler or Deike Strobel.

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Interessenkonflikt

S. Zundler und D. Strobel geben an, dass kein Interessenkonflikt besteht.

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

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Alexander Arlt, Oldenburg

Alexander Dechêne, Nürnberg

Andrea Riphaus, Frankfurt am Main

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Zundler, S., Strobel, D. Sonographische Differenzialdiagnostik fokaler Leberläsionen. Gastroenterologie 18, 3–15 (2023). https://doi.org/10.1007/s11377-022-00663-2

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