Bildgebung bei Mediastinaltumoren

Zusammenfassung

Die Einteilung des Mediastinums erfolgt anhand computertomografischer Aufnahmen in ein ventrales prävaskuläres, mittleres viszerales und dorsales paravertebrales Kompartiment. In den einzelnen Kompartimenten kommen verschiedene Tumorentitäten besonders häufig vor, die entsprechend kurz vorgestellt werden. Im Folgenden werden die typischen bildmorphologischen Zeichen in Röntgen, Sonografie, CT und MRT vorgestellt. Mithilfe der morphologischen Kriterien lassen sich oftmals einzelne Läsionstypen bzw. deren Malignitätsgrad nicht ausreichend abgrenzen. Daher spielen vor allem die funktionellen Informationen im PET und der MRT eine wichtige Rolle zur nicht invasiven Klassifikation. Zur Sicherung einer histologischen Diagnose steht mit den CT-gesteuerten Biopsiemöglichkeiten eine ambulant durchzuführende Option mit hoher diagnostischer Genauigkeit und geringen Komplikationen zur Verfügung.

Abstract

In computed tomography, the mediastinum is split into ventral prevascular, middle visceral and dorsal paravertebral compartments. Each compartment contains specific tumours which will be presented and discussed briefly. The focus is on image-based analysis of morphological signs to differentiate between entities using X-rays, ultrasound, CT and MRI. It is however difficult to differentiate between various types of lesions based on morphology and to estimate the grade of malignancy. For this reason, functional imaging techniques like PET and MRI are essential tools for detailed and non-invasive work-up. If a histological tissue examination is required, these tissue samples can be acquired using CT guided biopsies with high diagnostic yield and low complication rates.

Schlüsselwörter

Mediastinum - Bildgebung - Computertomografie - Magnetresonanztomografie - Tumor

Key words

mediastinum - imaging - computed tomography - magnetic resonance imaging - tumour

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