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Mediastinum

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Bildatlas der Lungen- und Pleurasonographie

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Zusammenfassung

Mediastinale Strukturen werden durch die Computertomographie und auch durch die Kernspintomographie umfassend dargestellt. Die transthorakale sonographische Untersuchung des Mediastinums (außer Echokardiographie) ist auch deshalb bisher nur wenig verbreitet. Ihr Einsatz ist jedoch sehr lohnenswert. Goldberg wies schon 1971 auf den suprasternalen sonographischen Zugangsweg ins Mediastinum hin. Das Verfahren geriet in den 70-er Jahren außerhalb der Kardiologie nahezu in Vergessenheit. Mitte der 80-er Jahre wurde in der Pädiatrie (Lengerke u. Schmid 1988; Liu et al. 1988) und auch in der Erwachsenenmedizin die Mediastinalsonographie erforscht und die Effizienz bewiesen (Braun 1983; Heckemann 1983; Blank 1986; Wernicke 1986; Brüggemann et al. 1991). In den folgenden Jahren erfolgte eine systematische Aufarbeitung der diagnostischen Möglichkeiten (Heizel 1985; Wernicke 1986, Wernicke 1991), die durch den Einsatz der Farbdopplersonographie und neuerdings durch die Kontrastmittelsonographie noch zusätzlich erweitert wurden (Betsch 1994; Dietrich et al. 1997, Dietrich et al. 1999; Blank et al. 2006; Caremani et al. 2009).

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Literatur

  • Beckh S, Bolcskei PL, Lessnau KD (2002) Real-time chest ultrasonography. A comprehensive review for the Pulmonologist. Chest 122: 1759–1773

    Article  PubMed  Google Scholar 

  • Betsch B (1994) Farbdopplersonographie des Mediastinums. Radiologe 34: 599–604

    CAS  PubMed  Google Scholar 

  • Betsch B, Knopp MV, van Kaick G (1992) Malignant tumors and lymphomas of the mediastinum: diagnosis and follow-up with color assisted doppler sonography. Eur J Cancer Res Clin Oncol 118: 107

    Google Scholar 

  • Betsch B, Berndt R, Knopp MV, Schmähl A, Trost U, Delorme S (1994) Vergleich von Computertomographie und B-Bild-Sonographie in der bildgebenden Diagnostik des Mediastinums. Bildgebung 61: 295–298

    CAS  PubMed  Google Scholar 

  • Blank W, Braun B (1995) Gewebsdiagnostik durch Dopplersonographie. Bildgebung 62: 31–35

    PubMed  Google Scholar 

  • Blank W, Braun B, Gekeler E (1986) Ultraschalldiagnostik und Feinnadelpunktion pleuraler, pulmonaler und mediastinaler Prozesse. In: Hansmann M (Hrsg) Ultraschalldiagnostik. Springer, Berlin Heidelberg New York Tokyo, S 562–565

    Google Scholar 

  • Blank W, Braun B, Schuler A, Wild K (1996a) Die percutane Sonographie zur Differenzierung der Dysphagie. Ultraschall Med [Suppl 1]: 32

    Google Scholar 

  • Blank W, Schuler A, Wild K, Braun B (1996b) Transthoracic sonography of the mediastinum. Eur J Ultrasound 3: 179–190

    Article  Google Scholar 

  • Blank W, Schwaiger U, Wild K, Braun B (1998) Die percutane Sonographie zur Darstellung des cervicalen Ösophagus. Ultraschall Med [Suppl 1]:4

    Google Scholar 

  • Bollen EC, Goci R, v Hofgrootenboer BE, Versteege CWM, Engelshove HA, Lamers RJ (1994) Interobserver variability and accuracy of computed tomographic assessment of nodal status in lung cancer. Ann Thorax Surg 58: 158–162

    Article  CAS  Google Scholar 

  • Bosch-Marcet J, Serres-Creixams X, Borras-Perez V et al. (2007) Value of sonographie for follow-up of mediastinal lymphadenopathy in children with tuberculosis. J Clinical Ultrasound 35 Issue 3: 118–124

    Article  Google Scholar 

  • Braun B (1983) Abdominelle und thorakale Ultraschalldiagnostik. In: Bock HE (Hrsg) Klinik der Gegenwart. Urban & Schwarzenberg, München, S 1141–1145

    Google Scholar 

  • Braun B (1992) Schilddrüse. In: Braun B, Günther R, Schwerk WB (Hrsg) Ultraschalldiagnostik. Lehrbuch und Atlas. ecomed, Landsberg/Lech, III-3.1

    Google Scholar 

  • Braun B, Blank W (2005) Sonographie von Hals und oberem Mediastinum. Internist 46(10): 1133–1145

    Article  CAS  PubMed  Google Scholar 

  • Brüggemann A, Greie A, Lepsien G (1991) Real-time-sonography of the mediastinum in adults: a study in 100 healthy volonteers. Surg Endosc 5: 150–153

    Article  PubMed  Google Scholar 

  • Caremani M, Benci A, Tacconi D et al. (2009) Sonographic management of mediastinal syndrom. J Ulrasound 12(2): 61–68

    Article  Google Scholar 

  • Castellino RA, Blank N, Hoppe RT et al. (1986) Hodgkin disease: contributions of chest CT in the initial staging evaluation. Radiology 160: 603–605

    CAS  PubMed  Google Scholar 

  • Dietrich CF, Liesen M, Wehrmann T, Caspary WF (1995) Mediastinal-sonographie: Eine neue Bewertung der Befunde. Ultraschall Med 16: 61

    Google Scholar 

  • Dietrich CF, Liesen M, Buhl R, Herrmann G, Kirchner I, Caspary WF, Wehrmann T (1997) Detection of normal mediastinal lymphnodes by ultrasonography. Acta Radiol 38: 965–969

    CAS  PubMed  Google Scholar 

  • Dietrich CF, Chickakli M, Burgon I, Wehrmann T, Wiewrodt R, Buhl R, Caspary WF (1999) Mediastinal lymphnodes demonstrated by mediastinal sonography: activity marker in patients with cystic fibrosis. J Clin Ultrasound 27: 9–14

    Article  CAS  PubMed  Google Scholar 

  • Ganesan S (2001) Sonographic approach to the superior mediastinum. Chest Radiology 11 (2): 71–73

    Google Scholar 

  • Goldberg GG (1971) Suprasternal ultrasonography. JAMA 15: 245–250

    Article  Google Scholar 

  • Gulati M, Venkataramu NK, Gupta S (2000) Ultrasound guided fine needle aspiration biopsy in mediasinal tunerculosis. Internat J Tuberculosis Lung 4 (12): 1164–1168

    CAS  Google Scholar 

  • Heckemann R (1983) Sonographische Tumordiagnostik im Mediastinum. Therapiewoche 33: 123–137

    Google Scholar 

  • Heitzmann EK (1988) The mediastinum. Springer, Berlin, Heidelberg, New York

    Google Scholar 

  • Heizel M (1985) Sonographische Topographie des oberen vorderen Mediastinums. Ultraschall 6: 101–109

    Article  Google Scholar 

  • Herth FJF, Becker HD (2003) Chest ultrasound; thoracic imaging; pleura mass; pleural effusion: Ultrasound guidance. Respiration 70: 84–94

    Google Scholar 

  • Herth FJF (2009) The Mediastinum. In: Bolliger CT, Herth FJF, Mayo PH, Miyazawa T, Beamis JF (eds) Clinical chest ultrasound. From the ICU to the Bronchoscopy Suite. Karger, Basel

    Google Scholar 

  • Janssen J, Johanns W, Lehnhardt M, Jakobeit C, Greiner L (1997) Die transkutane Sonographie des gastroösophagealen Übergangs im prospektiven Vergleich mit der Endoskopie. Dtsch Med Wochenschr 122: 1167–1171

    Article  CAS  PubMed  Google Scholar 

  • Lengerke HV v., Schmid HC (1988) Mediastinalsonographie im Kindesalter. Radiologe 28: 460–465

    Google Scholar 

  • Koh DM, Burke S, Davies N et al (2002) Transthoracic US of the Chest: clinical uses and applications. Radiographics 22: E1. Available: http://radiographics.rsnajnls.org/cgi/content/full/22/1/e1

    PubMed  Google Scholar 

  • Liu P, Daneman A, Stringer DA (1988) Real-time-sonography of mediastinal and juxtamediastinal masses in infants and children. J Can Assoc Radiol 39: 198–203

    CAS  Google Scholar 

  • Rosenberg JC (1993) Neoplasms of the, ediastinum. In: De Vita VT, Hellman S, Rosenberg SA (eds) Cancer: principles & practice of oncology. Lippincott, Philadelphia, pp 759–775

    Google Scholar 

  • Schuler A, Blank W, Braun B (1995) Sonographisch-interventionelle Diagnostik bei Thymomen. Ultraschall Med 16: 62

    Google Scholar 

  • Wernecke K, Peters PE, Galanski M (1986) Mediastinal tumors: evaluation of suprasternal sonographie. Radiology 159: 405–409

    CAS  PubMed  Google Scholar 

  • Wernecke K, Pötter R, Peters PE (1988) Parasternal medisatinal sonography: sensitivity in the detection of anterior mediastinal and subcarinal tumors. Am J Roentgenol 150: 1021–1026

    CAS  Google Scholar 

  • Wernecke K (1991) Mediastinale Sonographie, Untersuchungstechnik, diagnostische Effizienz und Stellenwert in der bildgebenden Diagnostik des Mediastinums. Springer, Berlin Heidelberg New York Tokyo

    Google Scholar 

  • Zhu SY et al (2005) Sonographic demonstration of the normal thoraxic esophagus. J Clin Ultrasound 33(1): 29–33

    Article  PubMed  Google Scholar 

  • Wernecke K, Peters PE, Galanski M (1986) Mediastinal tumors: evaluation of suprasternal sonography. Radiology 159: 405–409

    CAS  PubMed  Google Scholar 

Literatur

  • Annema JT, Veselic M, Versteegh MI, Rabe KF (2003a) Mediastinitis caused by EUS-FNA of a bronchogenic cyst. Endoscopy 35(9): 791–793

    Article  CAS  PubMed  Google Scholar 

  • Annema JT, Veselic M, Versteegh MI, Willems LN, Rabe KF (2003b) Mediastinal restaging: EUS-FNA offers a new perspective. Lung Cancer 42(3): 311–318

    Article  PubMed  Google Scholar 

  • Annema JT, Hoekstra OS, Smit EF, Veselic M, Versteegh MI, Rabe KF (2004) Towards a minimally invasive staging strategy in NSCLC: analysis of PET positive mediastinal lesions by EUS-FNA. Lung Cancer 44(1): 53–60

    Article  CAS  PubMed  Google Scholar 

  • Annema JT, Veselic M, Rabe KF (2005a) Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of sarcoidosis. Eur Respir J 25(3): 405–409

    Article  CAS  PubMed  Google Scholar 

  • Annema JT, Veselic M, Rabe KF (2005b) EUS-guided FNA of centrally located lung tumours following a non-diagnostic bronchoscopy. Lung Cancer 48(3): 357–361

    Article  PubMed  Google Scholar 

  • Annema JT, Versteegh MI, Veselic M, Voigt P, Rabe KF (2005c) Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of lung cancer and its impact on surgical staging. J Clin Oncol 23(33): 8357–8361

    Article  PubMed  Google Scholar 

  • Annema JT, Versteegh MI, Veselic M, Welker L, Mauad T, Sont JK et al. (2005d) Endoscopic ultrasound added to mediastinoscopy for preoperative staging of patients with lung cancer. JAMA 294(8): 931–936

    Article  CAS  PubMed  Google Scholar 

  • Annema JT, Bohoslavsky R, Burgers S et al. (2010) Implementation of endoscopic ultrasound for lung cancer staging. Gastrointest. Endosc Jan; 71(1): 64–70

    Article  Google Scholar 

  • Costabel U, Hunninghake GW (1999) ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Statement Committee. American Thoracic Society. European Respiratory Society. World Association for Sarcoidosis and Other Granulomatous Disorders. Eur Respir J 14(4): 735–737

    Article  CAS  PubMed  Google Scholar 

  • De Leyn P, Lardinois D, Van Schil PE, Rami-Porta R, Passlick B, Zielinski M et al. (2007) ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg 32(1): 1–8

    Article  PubMed  Google Scholar 

  • Detterbeck FC, Jantz MA, Wallace M, Vansteenkiste J, Silvestri GA (2007) Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines, 2nd edn. Chest 132 (3 Suppl): 202S–220S

    Article  PubMed  Google Scholar 

  • Eloubeidi MA, Seewald S, Tamhane A, Brand B, Chen VK, Yasuda I et al. (2004) EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies. Gastrointest Endosc 59(6): 627–633

    Article  PubMed  Google Scholar 

  • Eloubeidi MA, Tamhane A, Chen VK, Cerfolio RJ (2005a) Endoscopic ultrasound-guided fine-needle aspiration in patients with non-small cell lung cancer and prior negative mediastinoscopy. Ann Thorac Surg 80(4): 1231–1239

    Article  PubMed  Google Scholar 

  • Eloubeidi MA, Cerfolio RJ, Chen VK, Desmond R, Syed S, Ojha B (2005b) Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. Ann Thorac Surg 79(1): 263–268

    Article  PubMed  Google Scholar 

  • Fritscher-Ravens A, Sriram PV, Bobrowski C, Pforte A, Topalidis T, Krause C et al. (2000) Mediastinal lymphadenopathy in patients with or without previous malignancy: EUS-FNA-based differential cytodiagnosis in 153 patients. Am J Gastroenterol 95(9): 2278–2284

    Article  CAS  PubMed  Google Scholar 

  • Fritscher-Ravens A, Sriram PV, Topalidis T, Hauber HP, Meyer A, Soehendra N et al. (2000) Diagnosing sarcoidosis using endosonography-guided fine-needle aspiration. Chest 2000 118(4): 928–935

    Article  Google Scholar 

  • Hawes RH, Gress F, Kesler KA, Cummings OW, Conces DJ Jr. (1994) Endoscopic ultrasound versus computed tomography in the evaluation of the mediastinum in patients with non-small-cell lung cancer. Endoscopy 26(9): 784–787

    Article  CAS  PubMed  Google Scholar 

  • Herth FJ, Lunn W, Eberhardt R, Becker HD, Ernst A (2005) Transbronchial vs. transesophageal ultrasound-guided aspiration of enlarged mediastinal lymph nodes. Am J Respir Crit Care Med 171(10): 1164–1167

    Article  PubMed  Google Scholar 

  • Iwashita T, Yasuda I, Doi S, Kato T, Sano K, Yasuda S, Nakashima M, Hirose Y, Takaimi T, Moriwaki H et al. (2008) The yield of endoscopic ultrasound-guided fine needle aspiration for histological diagnosis in patients suspected of stage I sarcoidosis. Endoscopy 40(5): 400–405

    Article  CAS  PubMed  Google Scholar 

  • Kramer H, van Putten JW, Post WJ, van Dullemen HM, Bongaerts AH, Pruim J et al. (2004) Oesophageal endoscopic ultrasound with fine needle aspiration improves and simplifies the staging of lung cancer. Thorax 59(7): 596–601

    Article  CAS  PubMed  Google Scholar 

  • Larsen SS, Krasnik M, Vilmann P, Jacobsen GK, Pedersen JH, Faurschou P et al. (2002) Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management. Thorax 57(2): 98–103

    Article  CAS  PubMed  Google Scholar 

  • Larsen SS, Vilmann P, Krasnik M, Dirksen A, Clementsen P, Maltbaek N et al. (2005) Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies: preliminary results from a randomised clinical trial. Lung Cancer 49(3): 377–385

    Article  PubMed  Google Scholar 

  • Leblanc JK, Devereaux BM, Imperiale TF, Kesler K, Dewitt JM, Cummings O et al. (2004) Endoscopic ultrasound in non-small cell lung cancer and negative mediastinum on computed tomography. Am J Respir Crit Care Med

    Google Scholar 

  • Mountain CF, Dresler CM (1997) Regional lymph node classification for lung cancer staging. Chest 111(6): 1718–1723.

    Article  CAS  PubMed  Google Scholar 

  • Pedersen BH, Vilmann P, Folke K, Jacobsen GK, Krasnik M, Milman N et al. (1996) Endoscopic ultrasonography and real-time guided fine-needle aspiration biopsy of solid lesions of the mediastinum suspected of malignancy. Chest 110(2): 539–544

    Article  CAS  PubMed  Google Scholar 

  • Ringbaek TJ, Krasnik M, Clementsen P, Skov BG, Rasmussen EN, Vilmann P (2005) Transesophageal endoscopic ultrasound/ fine-needle aspiration diagnosis of a malignant adrenal gland in a patient with non-small cell lung cancer and a negative CT scan. Lung Cancer 48(2): 247–249

    Article  CAS  PubMed  Google Scholar 

  • Savides TJ, Perricone A (2004) Impact of EUS-guided FNA of enlarged mediastinal lymph nodes on subsequent thoracic surgery rates. Gastrointest Endosc 60(3): 340–346

    Article  PubMed  Google Scholar 

  • Schroder C, Schonhofer B, Vogel B (2005) Transesophageal echographic determination of aortic invasion by lung cancer. Chest 127(2): 438–442

    Article  PubMed  Google Scholar 

  • Stigt JA, Oostdijk AH, Timmer PR et al. (2009) Comparison of EUS-guided fine needle aspiration and integrated PET-CT in restaging after treatment for locally advanced non-small cell lung cancer. Lung Cancer Nov; 66(2): 198–204

    Article  Google Scholar 

  • Toloza EM, Harpole L, McCrory DC (2003a) Noninvasive staging of non-small cell lung cancer: a review of the current evidence. Chest 123 [1 Suppl]: 137S–146S

    Article  PubMed  Google Scholar 

  • Toloza EM, Harpole L, Detterbeck F, McCrory DC (2003b) Invasive staging of non-small cell lung cancer: a review of the current evidence. Chest 123 [1 Suppl]:157S–166S

    Article  PubMed  Google Scholar 

  • Tournoy KG, De Ryck F, Vanwalleghem LR, Vermassen F, Praet M, Aerts JG et al. (2008) Endoscopic ultrasound reduces surgical mediastinal staging in lung cancer: a randomized trial. Am J Respir Crit Care Med 177(5): 531–535

    Article  PubMed  Google Scholar 

  • Varadarajulu S, Hoffman BJ, Hawes RH, Eloubeidi MA (2004a) EUS-guided FNA of lung masses adjacent to or abutting the esophagus after unrevealing CT-guided biopsy or bronchoscopy. Gastrointest Endosc 60(2): 293–297

    Article  PubMed  Google Scholar 

  • Varadarajulu S, Schmulewitz N, Wildi SF, Roberts S, Ravenel J, Reed CE et al. (2004b) Accuracy of EUS in staging of T4 lung cancer. Gastrointest Endosc 59(3): 345–348

    Article  PubMed  Google Scholar 

  • Vilmann P, Krasnik M, Larsen SS, Jacobsen GK, Clementsen P (2005) Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy: a combined approach in the evaluation of mediastinal lesions. Endoscopy 37(9): 833–839

    Article  CAS  PubMed  Google Scholar 

  • Wallace MB, Silvestri GA, Sahai AV, Hawes RH, Hoffman BJ, Durkalski V et al. (2001) Endoscopic ultrasound-guided fine needle aspiration for staging patients with carcinoma of the lung. Ann Thorac Surg 72(6): 1861–1867

    Article  CAS  PubMed  Google Scholar 

  • Wallace MB, Ravenel J, Block MI, Fraig M, Silvestri G, Wildi S et al. (2004) Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography. Ann Thorac Surg 77(5): 1763–1768

    Article  PubMed  Google Scholar 

  • Wallace MB, Pascual JM, Raimondo M, Woodward TA, McComb BL, Crook JE et al. (2008) Minimally invasive endoscopic staging of suspected lung cancer. JAMA 299(5): 540–546

    Article  CAS  PubMed  Google Scholar 

  • Wildi SM, Hoda RS, Fickling W, Schmulewitz N, Varadarajulu S, Roberts SS et al. (2003) Diagnosis of benign cysts of the mediastinum: the role and risks of EUS and FNA. Gastrointest Endosc 58(3): 362–368

    PubMed  Google Scholar 

  • Wildi SM, Judson MA, Fraig M, Fickling WE, Schmulewitz N, Varadarajulu S et al. (2004) Is endosonography guided fine needle aspiration (EUS-FNA) for sarcoidosis as good as we think? Thorax 59(9): 794–799

    Article  CAS  PubMed  Google Scholar 

  • Williams DB, Sahai AV, Aabakken L, Penman ID, Van Velse A, Webb J et al. (1999) Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut 44: 720–726

    Article  CAS  PubMed  Google Scholar 

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  1. Klinikum am Steinenberg, Kreiskliniken Reutlingen, Medizinische Klinik, Akademisches Lehrkrankenhaus der Universität Tübingen, Steinenbergstraße 31, 72764, Reutlingen, Deutschland

    OA Dr. Wolfgang Blank

  2. Longziekten, C3-P, Leids Universitair Medisch Centrum, Postbus 9600, 2300, RC Leiden, Niederlande

    Dr. Jouke T. Annema, Dr. M. Veseliç & Prof. Dr. Klaus F. Rabe

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  1. OA Dr. Wolfgang Blank
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  2. Dr. Jouke T. Annema
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  3. Dr. M. Veseliç
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  4. Prof. Dr. Klaus F. Rabe
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  1. Internistische Praxis, Bahnhofstr. 16, 6830, Rankweil, Österreich

    Gebhard Mathis

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Blank, W., Annema, J.T., Veseliç, M., Rabe, K.F. (2010). Mediastinum. In: Mathis, G. (eds) Bildatlas der Lungen- und Pleurasonographie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03567-8_5

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