Kontrastverstärkte Ultraschalluntersuchung der Leber - Aktueller Wissensstand

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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