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Abdominelle Sonographie

Teil 3: Hepatobiliäres System und Pankreas

Abdominal sonography

Part 3: Hepatobiliary system and pancreas

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Der Gastroenterologe Aims and scope

Zusammenfassung

Die vorliegende Arbeit erläutert Indikationen und Möglichkeiten zeitgemäßer transabdomineller sonographischer Techniken für die Diagnostik biliärer und pankreatischer Erkrankungen. Die Sonographie hat sich in der Diagnostik von Gallenblasenerkrankungen praktisch uneingeschränkt durchgesetzt. Die Sensitivität liegt für die Cholezystolithiasis bei 98 % und wird kaum von einer anderen Indikation oder Bildgebung erreicht. Die Diagnostik der Choledocholithiasis bleibt auch mit modernster Technik entscheidend abhängig von der Erfahrung des Untersuchers. Die Sensitivität der konventionellen Sonographie zur Erkennung der Choledocholithiasis liegt zwischen 25 und 98 %. Die Endosonographie ist genauer (94–100 %). In der Pankreasdiagnostik ist die transabdominelle Sonographie das erste bildgebende Verfahren. Bei der akuten Pankreatitis ist insbesondere die Beurteilung und die Verlaufskontrolle der pankreatitischen Komplikationen (Pseudozysten, Gefäßkomplikationen, Obstruktionseffekte, Nekrosenbildung und Exsudation) wertvoll.

Abstract

This review summarizes the current knowledge and possibilities for transabdominal ultrasound techniques in the diagnosis of biliopancreatic diseases. Ultrasound has become widely accepted for the diagnosis of gall bladder diseases as the sensitivity for cholecystolithiasis can be up to 98 % and for bile duct stones it lies between 25 % and 98 % whereas endosonography is more accurate (94–100 %). In the diagnostics of the pancreas ultrasound is the first step in an imaging cascade. In cases of acute pancreatitis the assessment and follow-up of complications (e.g. exsudation, necrosis, pseudocysts, vascular complications and obstructive effects) is particularly valuable. Ductal adenocarcinoma appears to be less vascularized in comparison to the surrounding tissue, while endocrine tumors and some metastases are often hypervascularized. Transabdominal sonography is also helpful in the differentiation of cystic lesions into macrocystic and microcystic adenomas.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C.F. Dietrich gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Medizinische Klinik 2, Caritaskrankenhaus Bad Mergentheim, Uhlandstr. 7, 97980, Bad Mergentheim, Deutschland

    C.F. Dietrich, D. Schreiber-Dietrich & D. Nürnberg

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  1. C.F. Dietrich
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  2. D. Schreiber-Dietrich
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  3. D. Nürnberg
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Correspondence to C.F. Dietrich.

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Dietrich, C., Schreiber-Dietrich, D. & Nürnberg, D. Abdominelle Sonographie. Gastroenterologe 9, 159–171 (2014). https://doi.org/10.1007/s11377-013-0816-9

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  • DOI: https://doi.org/10.1007/s11377-013-0816-9

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