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Phlebologie 2001; 30(05): 124-131
DOI: 10.1055/s-0037-1617301
Original Articles
Schattauer GmbH

MRT-Diagnostik im Rahmen der Abklärung phlebologischer Krankheitsbilder

MRI in the diagnostic process of phlebologic disorders
B. M. Order
1   Abteilung für Radiologie, Christian-Albrechts-Universität Kiel
,
S. Müller-Hülsbeck
1   Abteilung für Radiologie, Christian-Albrechts-Universität Kiel
› Author Affiliations
Further Information

Publication History

Publication Date:
29 December 2017 (online)

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Zusammenfassung

Die aszendierende Phlebographie der Beinvenen stellt aktuell immer noch den Goldstandard für die Beurteilung des oberflächlichen und tiefen Venensystems der unteren Extremität dar und besitzt als diagnostisches Werkzeug für den Nachweis einer tiefen Beinvenenthrombose (TVT) einen hohen Stellenwert. Die nichtinvasive Duplexsonographie gewinnt zunehmend an Bedeutung und wird vorwiegend als erstes apparatives Diagnoseverfahren bei der Fragestellung einer TVT eingesetzt. Trotz bekannter Nachteile wie der Belastung des Patienten durch ionisierende Strahlung und der Gefahr kontrastmittelinduzierter Nebenwirkungen findet die konventionelle Phlebographie bei unklaren duplexsonographischen Befunden nach wie vor eine breite Anwendung. Die Magnetresonanztomographie (MRT) hat in den letzten Jahren erhebliche Fortschritte in ihrer technischen Weiterentwicklung erfahren. Es scheint, dass die moderne MR-Phlebographie mit ihrer Darstellung des venösen Gefäßsystems (und hier speziell bei der Diagnosestellung einer TVT) die konventionelle Phlebographie zurückdrängen kann. Aber auch die suffiziente Beurteilung der Weichteilverhältnisse zur Einschätzung eines postthrombotischen Syndroms und der chronischen venösen Insuffizienz (CVI) ist mit der MRT möglich.

Summary

Conventional venography is still acknowledged as the gold standard for the assessment of the deep and superficial venous system of the lower extremities and it is of great significance as a therapeutic tool for the diagnosis of deep venous thrombosis (DVT). Non-invasive duplex sonography has gained acceptance and in most institutions it is mainly used as the initial diagnostic tool for the assessment of a DVT. Despite of known disadvantages, like the exposure to ionizing radiation and complications associated with the use of iodinated contrast material, there is still a widespread use of conventional venography if duplex sonography results remain questionable. Throughout the last few years the technical development of magnetic resonance imaging has experienced considerable progress. It seems that modern MR-venography with it’s capacity to depict the venous vasculature (especially for the diagnosis of a DVT) is able to force back conventional venography. Furthermore magnetic resonance imaging provides visualization of soft tissue changes and contributes important information to monitor postthrombotic changes and to assess the grade of chronic venous insufficiency (CVI).

Résumé

La phlébologie conventionelle du système vasculaire des veines de jambes représente encore aujourd’hui la méthode standard pour juger soit les couches superficielles soit profondes du système veinaire des extrémités bas. En tant qu’outil de diagnostique d’une thrombose veinaire profonde (TVP) on lui accorde une grande importance. La sonographie duplex non-invasive gagne de plus en plus d’importance, surtout comme première méthode de diagnostique dans le cadre d’une TVP. Malgré les effets négatifs connus pour le client, p. ex. les radiations nocives et les effets secondaires nuisibles provoqués par les substances de contraste, la phlébographie traditionelle – tout en fournissant des résultats redoutables – se réjouit d’une grande acceptance. Ces dernières années la tomographie magnétique a connus des progrès considérables au niveau du procédé technique. Il semble que la phlébographie à la base de la tomographie magnétique moderne et sa possibilité de représenter le système vasculaire des veines (particulièrement dans le cadre de diagnostique d’une thrombose profonde venaire) peut remplacer la phlébologie traditionelle. En plus, la tomographie magnétique permet une visualisation et evaluation suffisante des changements dans les parties molles a cause d’un syndrome postthrombotique ou d’une insuffisance chronique de veines (ICV).

La diagnostique tomographie magnétique dans le cadre des maladies phlébologiques

Schlüsselwörter

MR-Phlebographie - kontrastmittelverstärkte MR-Phlebographie - tiefe Beinvenenthrombose (TVT) - chronische venöse Insuffizienz (CVI) - postthrombotisches Syndrom

Keywords

MR-venography - contrast-enhanced MR-venography - deep venous thrombosis (DVT) - chronic venous insufficiency (CVI) - postthrombotic changes

Mots clés

Phlébographie tomographie magnétique - thrombose veinaire profonde (TVP) - insufficience chronique de veines (ICV) - syndrome postthrombotique
 

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