Diagnostische Bildgebung bei Kopf- und Halserkrankungen in der pädiatrischen Notfallmedizin

Zusammenfassung

Eine Beurteilung pädiatrischer Notfälle wird in der Regel durch eine begrenzte Vorgeschichte und die eingeschränkte körperliche Untersuchung erschwert, wodurch es häufig zu überlappenden Befunden mit verschiedenen Krankheitsprozessen kommt. Für eine exakte und frühzeitige Diagnostik ist die Bildgebung somit von entscheidender Bedeutung. Eine Kenntnis der typischen klinischen und radiologischen Manifestationen verbreiteter pädiatrischer Notfälle des Kopf- und Halsbereichs sowie angeborener Fehlbildungen erlaubt dem untersuchenden Radiologen die Identifizierung der primären Ursache der Erkrankung und der damit in Verbindung stehenden Komplikationen, was wiederum eine sofortige operative Behandlung ermöglichen könnte. Das Bildgebungsprotokoll des einzelnen Patienten hängt dabei jeweils von seinem aktuellen klinischen Zustand ab. Für die Erstuntersuchung kommen Übersichtsaufnahmen, Ultraschall und kontrastmittelverstärkte Computertomografie (CT) infrage. Bei besonders komplexen Fällen könnte eine Magnetresonanztomografie (MRT) weiteren Aufschluss über das Ausmaß der Erkrankung geben.

Abstract

Evaluation of pediatric patients in the emergency setting is complicated by a limited history and physical examination, which often produce findings that overlap with multiple disease processes. Imaging therefore plays a critical role in achieving an accurate and timely diagnosis. Knowledge of the typical clinical and imaging manifestations of common pediatric head and neck emergencies and congenital abnormalities allows the interpreting radiologist to identify the primary cause of the condition as well as any associated complications that may warrant immediate surgical management. The specific imaging protocol depends on the patient’s clinical status. Radiography, ultrasonography, and contrast material-enhanced computed tomography all may be appropriate modalities for an initial examination. In especially difficult or complex cases, magnetic resonance imaging may offer additional detail with respect to the extent of disease.

1 © 2011 The Radiological Society of North America. All rights reserved. Originally published in English in RadioGraphics 2010; 30: 781 – 799. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inaccuracy or error arising from the translation from English to German.

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1 © 2011 The Radiological Society of North America. All rights reserved. Originally published in English in RadioGraphics 2010; 30: 781 – 799. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inaccuracy or error arising from the translation from English to German.