Normwerte in der Abdomensonografie – Aorta, Vena cava inferior, Niere

Zusammenfassung

Ziel: Normwerte in der B-Bild-Sonografie des Abdomens werden kontrovers diskutiert aufgrund der begrenzten Datenlage in der Literatur. Es erfolgt eine systematische Zusammenstellung bislang publizierter Daten bez. der großen retroperitonealen Gefäße und der Niere.

Methoden: Literatur-Recherche bezüglich Normwerten im Abdomen von 1970 – 2011 an gesunden über 18-jährigen Probanden. In Anlehnung an die Bestimmung von Referenzintervallen für Laborwerte werden Normwerte in der Regel mithilfe von 95 %-Referenzintervallen und den zugehörigen 90 %-Konfidenzintervallen bestimmt. Evaluiert wurden die Diameter der Aorta abdominalis und der Vena cava inferior sowie die Länge, Breite, Dicke, Parenchymdicke und das Volumen der Niere.

Ergebnisse: 61 Studien konnten ausgewertet werden. Die für die Aorta ermittelten Normwerte variieren erheblich in Abhängigkeit vom Alter und vom Geschlecht der Probanden, dem Messort und der Messmethode. Die oberen Intervallgrenzen der 95 %-Referenzintervalle liegen zwischen 17 und 40 mm. Der Durchmesser der Vena cava inferior ist abhängig von der Lagerung des Probanden, von der Lokalisation der Messung, von der Respiration und von der Ruheherzfrequenz. Normalbefunde bis zu 27 mm sind möglich. Einflussfaktoren auf die Nierengröße und das Nierenvolumen sind die Seite (rechts/links), das Alter der Probanden, das Geschlecht, anthropometrische Parameter und die ethnische Zugehörigkeit. Für die Nierenlänge kann als Normbereich für mitteleuropäische Frauen 9 cm – 12,8 cm und für Männer 9,2 cm – 13,3 cm angesehen werden. Für die Nierenbreite wurden Intervallgrenzen zwischen 3 cm und 7,1 cm, für die Nierendicke zwischen 2,9 und 6 cm, für die Parenchymdicke zwischen 1,1 cm und 2,3 cm und für das Nierenvolumen zwischen 59 und 230 ml eruiert.

Diskussion: Normwerte sind hilfreich für die Abgrenzung zahlreicher pathologischer Prozesse in den jeweiligen Organen.

Abstract

Objective: Reference values for B-mode abdominal ultrasound are controversially discussed due to the limited data in the literature. A systematic survey of data published so far is presented for the big retroperitoneal vessels and the kidneys.

Methods: A literature review of reference values in the abdomen from 1970 to 2011 in healthy subjects 18 years of age and older was undertaken. According to the determination of reference intervals for laboratory values, reference values are generally determined using 95 % reference intervals and their associated 90 % confidence intervals. The diameters of the abdominal aorta and the inferior vena cava were evaluated as well as the length, width, thickness, parenchymal thickness and volume of the kidneys.

Results: 61 studies were analysed. Reference values determined for the aorta vary considerably according to age and gender of the probands, measuring position and measuring technique. The upper interval limits of the 95 % reference intervals lie between 17 and 40 mm. The diameter of the inferior vena cava depends on the position of the patient, the measuring site, respiration and the resting heart rate. Normal results up to 27 mm can be encountered. Influencing factors on the size and volume of the kidneys are the side (right/left), age, gender, anthropometric parameters and the ethnic membership of the probands. For central European women, 9 cm – 12.8 cm can be regarded as the normal range of the length of the kidney and for men 9.2 cm – 13.3 cm. For the width of the kidney, interval limits were determined between 3 cm and 7.1 cm, for the thickness between 2.9 cm and 6 cm, for the parenchymal thickness between 1.1 cm and 2.3 cm and for the volume between 59 and 230 mL.

Discussion: Normal values are helpful in delimiting numerous pathological changes in the respective organs.

Schlüsselwörter

Normwerte - Aorta - Vena cava inferior - Niere

Key words

reference values - aorta - inferior vena cava - kidney

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