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Ultraschall Med 2024; 45(02): 118-146
DOI: 10.1055/a-2189-5050
DOI: 10.1055/a-2189-5050
Continuing Medical Education
Sonografie der Pleura
Article in several languages: English | deutsch
Zusammenfassung
Die hier präsentierte CME-Übersichtsarbeit erläutert die Aussagekraft der Pleurasonografie und gibt Hinweise zu deren Anwendung. Aufgrund der Impedanz-Unterschiede kann die Pleuralinie gut abgegrenzt werden. Mit hochauflösenden Geräten kann auch eine normale Pleura mit einer Dicke von 0,2 mm beurteilt werden. In diesem Artikel werden die Besonderheiten der Untersuchungstechnik mit der Kenntnis der Vortestwahrscheinlichkeit erläutert und die Indikationen der Pleurasonografie beschrieben. Die Pleurasonografie hat einen hohen Stellenwert: sowohl in der Notfall- und Intensivmedizin, präklinisch, ambulant und stationär, in der Hausarzt- wie auch in der Spezialarzt-Praxis der Pneumologen. Dargestellt werden die Besonderheiten in der Kindheit (Pädiatrie), wie auch in der Geriatrie. Das Erkennen eines Pneumothorax, auch in schwierigen Situationen, wie auch die Beurteilung des Pleuraergusses werden erläutert. Aufgrund der heutigen hochauflösenden Technik können sowohl die Pleura selbst wie auch kleine subpleurale Veränderungen beurteilt und diagnostisch verwertet werden. Sowohl die direkten wie auch indirekten sonografischen Zeichen und Begleiterscheinungen werden beschrieben und es wird der konkrete klinische Stellenwert der Sonografie dargestellt. Dargelegt werden zudem die Bedeutung und die Kriterien des konventionellen helligkeitskodierten B-Bildes, der Farbdoppler-Sonografie (CDS), mit oder ohne Spektralanalyse des Dopplersignals (SDS), sowie des Kontrastmittel-Ultraschalls (CEUS). Auch die Elastografie und ultraschallgestützte Interventionen sollen Erwähnung finden. Eine zugehörige weitere Arbeit beschäftigt sich mit den Erkrankungen des Lungenparenchyms und eine weitere Arbeit mit den Erkrankungen der Thoraxwand, des Zwerchfells und des Mediastinums.
Publication History
Article published online:
18 January 2024
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