Anwendung der Kontrastmittelsonografie im Kopf-Hals-Bereich: Update

Mithilfe der Kontrastmittelsonografie lässt sich die diagnostische Genauigkeit der konventionellen Sonografie in vielen Bereichen der HNO-Heilkunde erhöhen. Durch die Untersuchung werden Vaskularisation und Gewebeperfusion objektivierbar. Dies bietet vielversprechende Ansätze, beispielsweise zum Therapiemonitoring metastatischer zervikaler Lymphknoten oder im Rahmen der Behandlung vaskulärer Malformationen.

Abstract

With the help of contrast enhanced ultrasound, the diagnostic accuracy of conventional sonography can be increased in many areas of otorhinolaryngology. Vascularisation and tissue perfusion can be objectified through the examination. This offers promising approaches for example to monitor the therapy of metastatic cervical lymph nodes or in the treatment of vascular malformations. Contrast Enhanced Ultrasound (CEUS) also offers great potential for differential diagnosis, for example of thyroid nodules. Valid threshold values for the quantitative time intensity curve (TIC) analysis of cervical pathologies are currently still not available. Further studies are necessary. As there is currently no license for the use of contrast enhanced ultrasound in otorhinolaryngology patients must be informed about its off-label use before the examination. This article is intended to provide an overview of the current possibilities and to serve as an introduction to the topic.

Kernaussagen

• Der CEUS kann für verschiedene Fragestellungen innerhalb der HNO-Heilkunde die diagnostische Genauigkeit einer konventionellen Sonografie erhöhen.

• Die Anwendung von CEUS in der HNO-Heilkunde geschieht in der Regel als Off-Label-Use. Hierüber sind die Patienten aufzuklären.

• Der CEUS bietet vielversprechende Ansätze zum Therapiemonitoring, z.B. durch regelmäßige Verlaufskontrolle zervikaler Lymphknotenmetastasen.

• Durch CEUS wird die Beurteilung der Vaskularisation bzw. der Gewebeperfusion objektivierbar.

• Der CEUS bietet vielversprechende Ansätze, die sonografische Differenzialdiagnostik von Schilddrüsenknoten zu verbessern.

• Durch entsprechende Studien validierte Grenzwerte für die quantitative TIC-Analyse fehlen in der HNO-Heilkunde noch weitestgehend.

Schlüsselwörter

Kontrastmittelsonografie - CEUS - Vaskularisation - Therapiemonitoring - Lymphknotenmetastasen - Gefäßmalformationen

Keywords

Contrast enhanced ultrasound - CEUS - vascularisation - therapy monitoring - metastatatic lymph nodes - vascular malformations

Publication History

Article published online:
02 June 2023

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