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Kardiologie up2date 2014; 10(03): 223-238
DOI: 10.1055/s-0034-1378069
Diagnostische Verfahren und Bildgebung
© Georg Thieme Verlag KG Stuttgart · New York

Der rechte Ventrikel – welche bildgebende Modalität ist sinnvoll?

Daniel Urban
,
Matthias Grothoff
,
Philipp Lurz
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Publication History

Publication Date:
24 October 2014 (online)

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Abstract

For a long time the right ventricle was hardly noticed in the pathophysiology of cardiovascular diseases. The advancement in echocardiography and the increasing availability of magnetic resonance imaging (MRI) amended the understanding of the RV and led to a decisive improvement of diagnosis and treatment of cardiovascular diseases such as congenital heart disease or pulmonary hypertension. The use of radionuclide-based techniques or computed tomography (CT) can be helpful in certain settings. In most cases, the use of a multimodal approach will yield in the best treatment for patients with RV involvement.

Kernaussagen

  • Die echokardiografische Untersuchung des RV ist die Basisdiagnostik. Sie ist breit verfügbar, kostengünstig und zeichnet sich durch eine hohe räumliche und zeitliche Auflösung aus.

  • Bei Patienten mit schlechtem Schallfenster und bei bestimmten Fragestellungen bietet die kardiale MRT eine hervorragende Ergänzung zur Echokardiografie.

  • Insbesondere bei Patienten mit angeborenen Herzfehlern eignet sich die MRT zur Therapieplanung und zur Erfolgskontrolle nach chirurgischer oder interventioneller Therapie.

  • Mithilfe der Late-Gadolinium-Enhancement-MR-Bildgebung können myokardiale Nekrosen und Narben oder eine Fibrose visualisiert werden; eine Quantifizierung mittels T1-Mapping ist für den RV zum jetzigen Zeitpunkt nicht ausreichend validiert.

  • Die kardiale Multidetektor-CT und radionuklidbasierte Techniken sind in der nicht invasiven Bildgebung des rechten Ventrikels von untergeordneter Bedeutung und nur bei bestimmten Fragestellungen indiziert.

  • Die Weiterentwicklung von Hybridtechniken wird das Verständnis des RV in der Pathophysiologie kardiovaskulärer Erkrankungen weiter verbessern.

  • Ein multimodaler Ansatz ist der Schlüssel für eine optimale Beurteilung der RV-Anatomie und RV-Funktion.

 

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