Zusammenfassung
Ziel: Beurteilung einer umfassenden internistischen Ultraschalluntersuchung im Vergleich
zur Ganzkörper-MRT hinsichtlich kardiovaskulärer Risikofaktoren, metabolischem Syndrom,
maligner Tumoren und anderer therapeutisch relevanter Befunde.
Material und Methoden: 833 konsekutive Patienten (19 – 93 J., m 56,6 J.) erhielten Sonografie (hirnzuführende
Gefäße, Schilddrüse, Abdomen und Herz) und MRT-Untersuchung (Ganzkörper-MR-Angiografie,
MRT Kopf, Thorax, Abdomen, virtuelle Koloskopie). Die Analyse erfolgte retrospektiv
anhand der schriftlichen Befunde.
Ergebnisse: In der Detektion früher arteriosklerotischer Veränderungen (Intima-media-Verdickung,
nicht stenosierende Plaques, 33 % der Pat.) sowie der Steatosis hepatis als wichtiger
Parameter des metabolischen Syndroms (20,4 %) war die Sonografie der MRT deutlich
überlegen. Maligne Tumoren waren selten (1,4 %) und meist im Abdomen gelegen. MRT
und Sonografie waren gleichwertig in der Detektion der abdominellen Tumoren und kleiner
Leberherde. Ausschließlich im MRT darstellbar waren intrakranielle Befunde, maligne
intrathorakale Befunde sowie Kolonpolypen.
Schlussfolgerung: Hinsichtlich der Detektion früher Arteriosklerose sowie des metabolischen Syndroms
erwies sich die Sonografie überlegen. In der Darstellung tumoröser Veränderungen des
Bauchraums waren die Methoden gleichwertig. Die Ganzkörper-MRT mit virtueller Koloskopie
entdeckt zusätzlich krankhafte Veränderungen des Gehirns, des Thoraxraums sowie Kolonpolypen.
Abstract
Purpose: The benefit of ultrasound in comparison with full-body MRI during a medical checkup
in preventive health care was examined with regard to the detection of cardiovascular
risk factors, metabolic syndrome, malignant tumors and further relevant findings.
Materials and Methods: 833 consecutive patients (266 f/567 m, age: 19 – 93 y, mean age: 56.6 y) underwent
both ultrasound (extracranial carotid arteries, thyroid, abdominal ultrasound and
echocardiography) and whole-body MRI (whole-body MR angiography, head, thorax, abdomen
and virtual colonoscopy). For ultrasound examinations, DEGUM level III devices were
used (Siemens Acuson Antares, Siemens G60, Siemens, Erlangen). MRI examinations were
performed using a 1.5 Tesla MRI device (Siemens Avanto, Siemens, Erlangen). All patients
were reviewed retrospectively based on the written reports.
Results: Ultrasound was much more sensitive in detecting early atherosclerotic changes than
MRI angiography. In 33 % of the patients, manifestations of atherosclerosis were found.
Thoracic (3) and abdominal aortic and mesenteric artery aneurysms (3) were diagnosed
by both methods. Hepatic steatosis as an important risk factor of metabolic syndrome
was only found by ultrasound in 20.4 % of our patients. Malignant tumors were rare
in this population (1.4 %): all abdominal tumors except one renal oncocytoma were
found using both methods. MRI and ultrasound were equally sensitive with respect to
the detection of small liver foci. As expected, MRI was less sensitive than ultrasound
in the diagnosis of thyroid nodes. For intracranial diagnoses, malignant intrathoracic
findings and colonic polyps, ultrasound is not the method of choice.
Conclusion: For the detection of lifestyle-dependent diseases such as atherosclerosis and metabolic
syndrome, ultrasound examination was more sensitive than MRI, and the same was true
for the early detection of thyroid diseases. For the detection of malignant abdominal
tumors, both methods were equally sensitive. Whole-body MRI can additionally detect
pathological changes in the head, lungs and colon.
Key words
arteriosclerosis - metabolic disorders - screening - MR imaging - 2 D ultrasound
