Der Einsatz der farbkodierten Duplexsonographie (FKDS) erhöht die diagnostische Sicherheit in der Abdomensonographie

 

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Zusammenfassung

Der Einsatz der farbkodierten Duplexsonographie (FKDS) erhöht die diagnostische Sicherheit in der Abdomensonographie: Im konventionellen B-Bild ist eine sichere differenzialdiagnostische Unterscheidung pathologischer Raumforderungen von pathologischen Gefäßstrukturen nicht immer möglich. Ziel: Klärung der Frage, bei wie viel Prozent der sonographischen Untersuchungen Befunde vorliegen, bei denen durch die zusätzliche FKDS-Untersuchung die differenzialdiagnostische Sicherheit verbessert werden kann. Methodik: In einer prospektiven Analyse wurden 1350 abdominelle Sonographien ausgewertet. Die Untersuchungen erfolgten an einem Toshiba SSA 140 A-Ultraschallgerät mit einem 3,75 MHz- bzw. 2,5 MHz-Schallkopf. Befunde, die im B-Bild nicht eindeutig interpretiert werden konnten, wie z. B. lymphknotenverdächtige Strukturen, diskreter Aszites, Harnaufstau, Zysten und Cholestasephänomene, wurden durch eine ergänzende FKDS-Untersuchung abgeklärt. Ergebnisse: Es fanden sich im B-Bild 327 Befunde (= 24 % der Untersuchungen), deren differenzialdiagnostische Zuordnung durch die FKDS-Untersuchung erleichtert wurde. Bei 73 dieser Patienten (= 22 % der Problemfälle bzw. 5 % der Untersuchten) war in der FKDS-Untersuchung Blutfluss nachweisbar. Somit war die FKDS-Untersuchung bei 5 % der Untersuchten diagnostisch wegweisend. Schlussfolgerung: Der gezielte Einsatz der FKDS zur Abklärung unklarer Befunde im B-Bild vermindert die Rate an Fehldiagnosen. Dieses gilt insbesondere bei Patienten mit portaler Hypertension.

Abstract

Colour Doppler sonography (CDS) avoids misinterpretation of abdominal ultrasonography. Differential diagnosis of pathological structures found by grey-scale sonography can be difficult in many cases. Aim: The present study aimed to determine how often additional colour Doppler sonography could be of benefit to avoid misinterpretation of grey-scale ultrasound images. Methods: 1350 abdominal sonograms were examined. The sonographic examination was performed using a Toshiba SSA-140 A-ultrasound machine (3.75 MHz and 2.5 MHz-transducer). Findings which could be misinterpreted in grey-scale images, e. g. structures suspicious of lymph nodes, small areas of ascites, hydronephrosis, cysts or cholestasis, were examined by additional colour Doppler sonography. Results: 327 findings (= 24 % of the cases) were classified as requiring additional examination by colour Doppler sonography. In 73 of these cases (= 22 % of cases having additional CDS), CDS identified blood flow in the pathological structure, which avoided misinterpretation of the grey-scale imaging. Conclusion: Additional CDS avoids misinterpretation of grey-scale sonography especially in patients with portal hypertension.

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Dr. med. Alexandra von Herbay

Universitätsklinikum Düsseldorf · Medizinische Klinik · Klinik für Gastroenterologie, Hepatologie und Infektiologie

Moorenstraße 5 · 40225 Düsseldorf ·

Phone: +49-211-8118713

Fax: +49-211-8118752

Email: Alexandra.vonHerbay@uni-duesseldorf.de