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Sonographie der Nieren und Nierengefäße

Teil II: Fokale Ultraschallbefunde, Doppler- und Farbdopplersonographie

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Zusammenfassung

Die Sonographie ist bei vielen fokalen Läsionen der Niere das diagnostische Mittel der Wahl. Zysten können anhand festgelegter Kriterien sicher erkannt werden, die Diagnose Zystennieren kann bei positiver Familienanamnese allein nach sonographischen Kriterien gestellt werden. Bei tumorösen Raumforderungen der Niere gelingt die Differenzierung zwischen benignen Angiomyolipomen und malignen Raumforderungen ebenfalls mit hoher Treffsicherheit, wobei maligne Raumforderungen <2 cm übersehen werden können. Die Farbdopplersonographie hat ihren besonderen Stellenwert bei der schnellen, nichtinvasiven Diagnose von Nierenarterienstenosen. Ebenso können anhand eines erhöhten Widerstandsindex urodynamisch wirksame von unwirksamen Hydronephrosen unterschieden werden. Ein erhöhter renaler Widerstandsindex ist darüber hinaus auch ein zuverlässiger prognostischer Parameter für das Nierenüberleben bei einer Vielzahl von Nierenerkrankungen, bei Nierenarterienstenosen und Transplantatnieren.

Abstract

Ultrasonography has become the method of choice in the detection and characterization of fokal renal lesions. Even small renal cysts can be detected reliably and differentiated from malignant lesions according to fixed criteria. In the presence of a positive family history ultrasonography allows the definitive diagnosis of polycystic kidney disease. Benign angiomyolipomas can be detected and differentiated from malignant renal lesions. However, small malignant lesions (<2 cm) may be missed. Color Doppler sonography has become a standard method to screen for renal artery stenosis because it allows a fast, non-invasive and cost effective diagnosis. A raised renal resistance index allows the differentiation of urodynamically significant from non-significant hydronephrosis. Furthermore the renal resistance index can be used as a reliable prognostic marker for renal survival in patients with a variety of renal diseases, renal artery stenosis and transplantation.

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Authors and Affiliations

  1. Abteilung Nephrologie, Zentrum für Innere Medizin, Klinikum Minden, Minden

    J. Radermacher

  2. Abteilung Nephrologie, Klinikum Minden, Friedrichstraße 17, 32427, Minden

    J. Radermacher

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  1. J. Radermacher
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Radermacher, J. Sonographie der Nieren und Nierengefäße. Internist 44, 1413–1432 (2003). https://doi.org/10.1007/s00108-003-1079-1

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  • DOI: https://doi.org/10.1007/s00108-003-1079-1

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