Radiologische Abklärung inzidenteller pulmonaler Rundherde

  • H. Prosch
  • C. Schaefer-Prokop
Chapter

Zusammenfassung

Der Nachweis pulmonaler Rundherde hat sich in den letzten Jahren vervielfacht. Die hohe Prävalenz von Rundherden, von denen die große Mehrheit benigne ist, stellt ein häufiges Problem in der klinischen Routine dar. Ziel der bildgebenden Diagnostik ist es, bei der Abklärung von pulmonalen Rundherden maligne Prozesse mit hoher diagnostischer Sicherheit von benignen Veränderungen zu differenzieren. Das diagnostische Vorgehen richtet sich dabei nach der Vortestwahrscheinlichkeit, dass der Rundherd maligne ist. Kleine Rundherde (< 8 mm) werden durch Verlaufsuntersuchungen weiter beobachtet, wobei sich die Intervalle nach der klinischen Vortestwahrscheinlichkeit und der Größe richten. Größerer Rundherde (>8 mm) werden entweder durch Verlaufsuntersuchungen oder eine PET/CT weiter nichtinvasiv abgeklärt oder biopsiert. Bei sehr hoher Vortestwahrscheinlichkeit für das Vorhegen einer Malignität wird eine Resektion des Rundherds empfohlen.

Schlüsselwörter

Bronchialkarzinom Computertomographie Pulmonale Metastasen Biopsie Malignität 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • H. Prosch
    • 1
  • C. Schaefer-Prokop
    • 2
  1. 1.Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien,Allgemeines Krankenhaus WienWien
  2. 2.Radiologie, Meander Medical CenterAmeersfoort und Radboud UniversitaetNijmegen

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