Zusammenfassung
Die Bedeutung der konventionellen Sonographie zur Detektion und Differenzialdiagnose
von Lebertumoren wird insbesondere in der (angloamerikanischen) radiologischen Literatur
im Vergleich zu den konkurrierenden bildgebenden Verfahren kritisch gesehen. Durch
die Einführung von Echosignalverstärkern konnte der Nachteil gegenüber den konkurrierenden
kontrastverstärkten Verfahren Computertomographie (CT) und Magnetresonanztomographie
(MRT) ausgeglichen werden.
Die primär unizentrisch erhobenen Daten bezüglich der verbesserten Detektion durch
die kontrastverstärkte Sonographie konnten mittlerweile multizentrisch bestätigt werden.
Es konnte gezeigt werden, dass die echosignalverstärkte Sonographie mehr Metastasen
detektiert als die konventionelle Sonographie; dies gilt insbesondere für kleine
Metastasen. Wir beschreiben den aktuellen Stand der kontrastverstärkten Sonographie
zur Detektion und Charakterisierung von Lebertumoren.
Abstract
The diagnostic process, differential diagnosis and continuing routine follow-up of
patients with focal liver lesions require an easily available, reliable and cost-effective
diagnostic method. Ultrasound is a widely used method for the detection of liver lesions,
but it has generally been regarded as inferior to contrast-enhanced computed tomography
(CT) and magnetic resonance imaging (MRI). Recent advances in contrast-enhanced ultrasound
(CEUS) have improved the detection rate to a level similar to that attained with CT
and MRI. Because of the high spatial resolution of ultrasound, CEUS can also detect
metastases smaller than 1 cm. This has been demonstrated in several single-centre
studies and recently also a European multi-centre study. This review focuses on the
recent advances of CEUS in detecting and characterizing focal liver lesions.
Schlüsselwörter
echosignalverstärkte Sonographie - SonoVue®
- Lebersonographie - fokal noduläre Hyperplasie - hepatozelluläres Adenom - Lebermetastasen
- hepatozelluläres Karzinom - lokal ablative Verfahren
Key words
contrast enhanced
sonography - SonoVue®
- liver sonography - focal nodular hyperplasia - hepatocellular adenoma - liver metastases
- hepatocellular carcinoma - local ablative therapy
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Prof. Dr. Christoph F. Dietrich
Innere Medizin 2, Caritas-Krankenhaus Bad Mergentheim
Uhlandstraße 7
97980 Bad Mergentheim
Phone: 07931/582201
Fax: 07931/582290
Email: christoph.dietrich@ckbm.de