Pulmonale Manifestationen bei systemischen Vaskulitiden

Zusammenfassung

Die pulmonalen Vaskulitiden sind Kleingefäßvaskulitiden und umfassen neben der Wegener-Granulomatose die mikroskopische Polyangiitis und das Churg-Strauss-Syndrom. Die Takayasu-Arteriitis als Großgefäßvaskulitis führt zu Stenosen an den Pulmonalarterien.
Für die Interpretation der radiologischen Befunde sind Kenntnisse des oft mehrphasigen Krankheitsverlaufes und des klinischen Erscheinungsbildes der Lungenmanifestationen hilfreich. Daher vermittelt dieser Artikel neben den radiologischen Befunden im Übersichtsbild und im hochauflösenden CT auch klinische Aspekte der pulmonalen Vaskulitiden. Neben der Bestimmung der Krankheitsausdehnung steht die Festlegung der Krankheitsaktivität im Vordergrund der bildgebenden Diagnostik. In diesem Zusammenhang wird auch auf die Therapieprinzipien eingegangen.

Abstract

Pulmonary vasculitides predominantly involve the small arterioles, capillaries and venules and include Wegener's granulomatosis, microscopic polyangiitis and the Churg-Strauss syndrome. Takayasu's arteriitis is a large vessel disease and may affect the main pulmonary arteries causing stenoses and occlusions.

Knowledge of the natural course of disease and of clinical manifestations of pulmonary disease is helpful for an understanding of imaging findings. For this reason this article gives an overview not only of radiologic findings in chest X-ray and high resolution CT of the lungs but as well of clinical aspects of pulmonary vasculitides. Next to determination of disease extension the determination of disease activity is in the foreground of diagnostic imaging in vasculitides. Within this context principals of immunosuppressive therapy will be recognized.

Keywords

Pulmonary vasculitides - chest X-ray - high resolution computed tomography - diagnosis - disease activity - therapy

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