Normwerte in der Abdomensonografie – biliopankreatisches System und Milz

Zusammenfassung

Ziel: Normwerte in der B-Bild-Sonografie des Abdomens werden aufgrund der begrenzten Datenlage in der Literatur kontrovers diskutiert. Es erfolgt eine systematische Zusammenstellung bislang publizierter Daten bezüglich des biliopankreatischen Systems und der Milz. Methoden: Literatur-Recherche bez. Normwerten im Abdomen von 1970 – 2010 an gesunden Probanden. In Anlehnung an die Bestimmung von Referenzintervallen für Laborwerte werden Normwerte in der Regel mithilfe von 95 %-Referenzintervallen und den zugehörigen 90 %-Konfidenzintervallen bestimmt. Evaluiert wurden die Gallenblase, die Gallenblasenwand, die Gallengänge, das Pankreas und die Milz. Ergebnisse: 70 Studien konnten ausgewertet werden. Die Vergleichbarkeit der Daten ist eingeschränkt, da unterschiedliche Kollektive untersucht und verschiedene Messmethoden angewendet wurden. Insbesondere für das Gallenblasenvolumen unterscheiden sich die in der Literatur angegebenen Messwerte quantitativ erheblich. Zur Gallenblasengröße ist die Datenlage unzureichend. Für die Wanddicke der Gallenblase kann als Normwert ca. 3 mm angesehen werden. Die für den Ductus hepaticus communis bzw. Ductus hepatocholedochus ableitbaren Normwerte liegen in Abhängigkeit vom Messort und den untersuchten Kollektiven zwischen 5 und 9 mm. Die publizierten Messwerte für die Pankreasgröße differieren ebenfalls erheblich. Als obere Normgrenze für die Milzlänge ergibt sich aus den meisten Publikationen um 12 cm, bei jungen, großen athlethischen Männern bis 15 cm. Diskussion: Normwerte sind hilfreich für die Abgrenzung zahlreicher pathologischer Prozesse in den jeweiligen Organen.

Abstract

Objective: Reference values for B-mode abdominal ultrasound are controversially discussed due to the limited data in the literature. A systematic survey of the data published so far is presented for the biliopancreatic system and the spleen. Methods: A literature review of reference values in the abdomen from 1970 to 2010 in healthy subjects 18 years of age and older was carried out. According to the determination of reference intervals for laboratory values, reference values are generally determined using 95 %-reference intervals and their associated 90 %-confidence intervals. The gallbladder, gallbladder wall, bile ducts, pancreas and the spleen were evaluated. Results: 70 studies were analysed. The comparability of the data is limited, because different collectives were studied and diverse measuring techniques were used. In particular, gallbladder volume measurements reported in the literature differ substantially. Data for the size of the gallbladder are insufficient. Deducible reference values for the common hepatic duct or, respectively, the common bile duct lie between 5 and 9 mm in dependency on the measuring position and the collective analysed. The published measurement values for the size of the pancreas also vary considerably. In most of the publications the upper limit of normal for the length of the spleen amounts to around 12 cm, in young, athletic men up to 15 cm. Discussion: Normal values are helpful in delimiting numerous pathological changes in the respective organs.

Schlüsselwörter

Normwerte - Pankreas - Milz

Key words

reference values - pancreas - spleen

Literatur

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