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Nicht-alkoholische Fettlebererkrankung pp 107–118Cite as

Sonografische Fettleberdiagnostik

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Zusammenfassung

Trotz der vielfältigen Fortschritte sonografischer Techniken sind die sichere Diagnose und vor allem die richtige Einschätzung des Krankheitswertes eines isolierten sonografischen Fettleberbildes ohne nachweisbare laborchemische Veränderungen bzw. Risikoscores schwierig geblieben. Dies gilt auch für die Quantifizierung der Fettinfiltration und somit deren prognostische Bedeutung und die Abgrenzung der Leberzirrhose. Dies gilt gleichermaßen für die Sonografie, Computertomografie und Magnetresonanztomografie. Sonografisch erfasst werden können beispielsweise die Lebergröße, die Abrundung der Leberform, die Zunahme der Echogenität des Leberparenchyms, die Schall-abschwächung und somit Unschärfe tiefer gelegener Strukturen. Ergänzt eingesetzt werden elastografische Verfahren, sowohl die Scherwellen- als auch die Kompressionselastografie. Aber auch die Beurteilung umgebender Organe und Gefäßstrukturen (etwa Milz, Pankreas, Umgehungskreisläufe, Aszites) sowie der Nachweis oder Ausschluss einer perihepatischen Lymphadenopathie sind für die Diagnostik, Stadienbestimmung und Differenzialdiagnose von Bedeutung. Das Kapitel beschreibt und bewertet die aktuellen sonografischen Kriterien einer Fettleber und deren klinische Bedeutung.

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Authors and Affiliations

  1. Department Allgemeine Innere Medizin (DAIM), Kliniken Salem, Beau-Site und Permanence, Bern, Schweiz

    Christoph F. Dietrich

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  1. Christoph F. Dietrich
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Correspondence to Christoph F. Dietrich .

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Editors and Affiliations

  1. Medizinische Klinik u. Poliklinik II, Universititätsklinikum Würzburg, ZIM, Würzburg, Bayern, Deutschland

    Andreas Geier

  2. Medizinische Klinik, Universitätsklinikum Bochum GmbH, Bochum, Deutschland

    Ali Canbay

  3. Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg, Saarland, Deutschland

    Frank Lammert

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Dietrich, C.F. (2022). Sonografische Fettleberdiagnostik. In: Geier, A., Canbay, A., Lammert, F. (eds) Nicht-alkoholische Fettlebererkrankung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62484-5_10

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  • DOI: https://doi.org/10.1007/978-3-662-62484-5_10

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  • Online ISBN: 978-3-662-62484-5

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