Zusammenfassung
Der Einsatz der farbkodierten Duplexsonographie (FKDS) erhöht
die diagnostische Sicherheit in der Abdomensonographie: Im konventionellen
B-Bild ist eine sichere differenzialdiagnostische Unterscheidung pathologischer
Raumforderungen von pathologischen Gefäßstrukturen nicht immer
möglich. Ziel: Klärung der Frage, bei wie viel
Prozent der sonographischen Untersuchungen Befunde vorliegen, bei denen durch
die zusätzliche FKDS-Untersuchung die differenzialdiagnostische Sicherheit
verbessert werden kann. Methodik: In einer prospektiven
Analyse wurden 1350 abdominelle Sonographien ausgewertet. Die Untersuchungen
erfolgten an einem Toshiba SSA 140 A-Ultraschallgerät mit einem
3,75 MHz- bzw. 2,5 MHz-Schallkopf. Befunde, die im B-Bild nicht
eindeutig interpretiert werden konnten, wie z. B.
lymphknotenverdächtige Strukturen, diskreter Aszites, Harnaufstau, Zysten
und Cholestasephänomene, wurden durch eine ergänzende
FKDS-Untersuchung abgeklärt. Ergebnisse: Es fanden
sich im B-Bild 327 Befunde (= 24 % der
Untersuchungen), deren differenzialdiagnostische Zuordnung durch die
FKDS-Untersuchung erleichtert wurde. Bei 73 dieser Patienten
(= 22 % der Problemfälle bzw.
5 % der Untersuchten) war in der FKDS-Untersuchung Blutfluss
nachweisbar. Somit war die FKDS-Untersuchung bei 5 % der
Untersuchten diagnostisch wegweisend. Schlussfolgerung:
Der gezielte Einsatz der FKDS zur Abklärung unklarer Befunde im B-Bild
vermindert die Rate an Fehldiagnosen. Dieses gilt insbesondere bei Patienten
mit portaler Hypertension.
Abstract
Colour Doppler sonography (CDS) avoids misinterpretation of
abdominal ultrasonography. Differential diagnosis of pathological structures
found by grey-scale sonography can be difficult in many cases.
Aim: The present study aimed to determine how often
additional colour Doppler sonography could be of benefit to avoid
misinterpretation of grey-scale ultrasound images. Methods: 1350 abdominal sonograms were examined. The
sonographic examination was performed using a Toshiba SSA-140 A-ultrasound
machine (3.75 MHz and 2.5 MHz-transducer). Findings which could
be misinterpreted in grey-scale images, e. g. structures suspicious of
lymph nodes, small areas of ascites, hydronephrosis, cysts or cholestasis, were
examined by additional colour Doppler sonography. Results: 327 findings (= 24 % of
the cases) were classified as requiring additional examination by colour
Doppler sonography. In 73 of these cases (= 22 % of
cases having additional CDS), CDS identified blood flow in the pathological
structure, which avoided misinterpretation of the grey-scale imaging.
Conclusion: Additional CDS avoids misinterpretation of
grey-scale sonography especially in patients with portal hypertension.
Schlüsselwörter
Doppler - Ultraschall - Leber - Abdomen - Shunt
Key words
Doppler - Ultrasonography - Liver - Abdomen - Shunt
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Dr. med. Alexandra von Herbay
Universitätsklinikum Düsseldorf · Medizinische
Klinik · Klinik für Gastroenterologie, Hepatologie und
Infektiologie
Moorenstraße 5 · 40225 Düsseldorf ·
Telefon: +49-211-8118713
Fax: +49-211-8118752
eMail: Alexandra.vonHerbay@uni-duesseldorf.de
