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Endoskopie heute 2008; 21(3): 156-165
DOI: 10.1055/s-2008-1077004
Originalarbeit

© Georg Thieme Verlag Stuttgart ˙ New York

Fortschritte in der Dünndarmradiologie

Advances in Small Bowel ImagingA. G. Schreyer1 , O. Hamer1 , S. Feuerbach1
  • 1Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
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Publication History

Publication Date:
23 October 2008 (online)

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Zusammenfassung

Die MRT- bzw. CT-basierte Untersuchung des Dünndarms hat bei chronisch-entzündlichen Darmerkrankungen (CED) wie bei der Tumorsuche die konventionelle radiologische Technik der Dünndarmdoppelkontrastuntersuchung weitgehend abgelöst. Im vorliegenden Übersichtsartikel werden dazu die MRT, CT sowie die hochauflösende Sonografie des Dünndarms bei CED kritisch diskutiert. Der zweite Teil des Artikels befasst sich mit der Gefäßdiagnostik des Darmes. Hier wird der anstehende Paradigmenwechsel der Blutungs- wie auch Ischämiediagnostik des Darmes erläutert. Dabei wird gezeigt, dass ein Mehrzeilen-CT zur Blutungssuche primär eingesetzt werden sollte, wobei die Angiografie in Kombination mit der CT den Fällen mit weiter unklarer Situation oder einer potenziellen Embolisation vorbehalten sein sollte. Auch die primäre Abklärung von Ischämien sollte zunächst durch Mehrzeilen-CTs erfolgen, zumal eine relevante Einengung der möglichen Differenzialdiagnosen durch die Schnittbildgebung erreicht werden kann.

Abstract

Currently MR- as well as CT-imaging of the small bowel is considered as the new standard of reference for diagnosis of inflammatory bowel disease (IBD) replacing the conventional small bowel fluoroscopy. In this article we will discuss the application of MRI, CT and high resolution ultrasound for small bowel assessment in patients with IBD. Additionally we will focus on the changing paradigms in vascular diagnosis of the small bowel. Based on the most recent literature we recommend the primary bleeding and ischemia diagnosis based on high resolution multislice CT having the added value of excluding important differential diagnosis in these patients.

Schlüsselwörter

MRT - CT - Dünndarm - CED - mesenteriale Ischämie - Darmblutung

Key words

MRI - CT - small bowel - IBD - mesenteric ischemia - hemorrhage

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PD Dr. A. G. Schreyer

Universitätsklinikum Regensburg · Institut für Röntgendiagnostik

Franz-Josef-Strauss-Allee 11

93053 Regensburg

Phone: 09 41 / 9 44 74 01

Email: andreas.schreyer@klinik.uni-r.de

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