Zusammenfassung
Ziel: Normwerte in der B-Bild-Sonografie des Abdomens werden aufgrund der begrenzten Datenlage
in der Literatur kontrovers diskutiert. Es erfolgt eine systematische Zusammenstellung
bislang publizierter Daten bezüglich des biliopankreatischen Systems und der Milz.
Methoden: Literatur-Recherche bez. Normwerten im Abdomen von 1970 – 2010 an gesunden 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 Gallenblase, die Gallenblasenwand, die Gallengänge,
das Pankreas und die Milz. Ergebnisse: 70 Studien konnten ausgewertet werden. Die Vergleichbarkeit der Daten ist eingeschränkt,
da unterschiedliche Kollektive untersucht und verschiedene Messmethoden angewendet
wurden. Insbesondere für das Gallenblasenvolumen unterscheiden sich die in der Literatur
angegebenen Messwerte quantitativ erheblich. Zur Gallenblasengröße ist die Datenlage
unzureichend. Für die Wanddicke der Gallenblase kann als Normwert ca. 3 mm angesehen
werden. Die für den Ductus hepaticus communis bzw. Ductus hepatocholedochus ableitbaren
Normwerte liegen in Abhängigkeit vom Messort und den untersuchten Kollektiven zwischen
5 und 9 mm. Die publizierten Messwerte für die Pankreasgröße differieren ebenfalls
erheblich. Als obere Normgrenze für die Milzlänge ergibt sich aus den meisten Publikationen
um 12 cm, bei jungen, großen athlethischen Männern bis 15 cm. 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 the data published so
far is presented for the biliopancreatic system and the spleen. Methods: A literature review of reference values in the abdomen from 1970 to 2010 in healthy
subjects 18 years of age and older was carried out. 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
gallbladder, gallbladder wall, bile ducts, pancreas and the spleen were evaluated.
Results: 70 studies were analysed. The comparability of the data is limited, because different
collectives were studied and diverse measuring techniques were used. In particular,
gallbladder volume measurements reported in the literature differ substantially. Data
for the size of the gallbladder are insufficient. Deducible reference values for the
common hepatic duct or, respectively, the common bile duct lie between 5 and 9 mm
in dependency on the measuring position and the collective analysed. The published
measurement values for the size of the pancreas also vary considerably. In most of
the publications the upper limit of normal for the length of the spleen amounts to
around 12 cm, in young, athletic men up to 15 cm. Discussion: Normal values are helpful in delimiting numerous pathological changes in the respective
organs.
Schlüsselwörter
Normwerte - Pankreas - Milz
Key words
reference values - pancreas - spleen
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Prof. Christoph F. Dietrich
Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim
Uhlandstr. 7
97980 Bad Mergentheim
Phone: ++ 49/79 31/58 22 01
Fax: ++ 49/79 31/58 22 90
Email: christoph.dietrich@ckbm.de
