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Infektionskrankheiten und Verletzungen der Harnblase und der ableitenden Harnwege

Infectious diseases and injuries of bladder and urinary tract

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Zusammenfassung

Beim Harnwegsinfekt handelt es sich um die häufigste Infektionskrankheit in Deutschland. Seine Abklärung erfordert in der Regel keine über die Sonographie hinausgehende Bildgebung, die Diagnose wird maßgeblich über die Klinik gestellt. Computertomographie (CT) und Magnetresonanztomographie (MRT) dienen in ausgewählten Fällen (z. B. rezidivierende oder atypische und komplizierte Verläufe) der Ursachenabklärung und dem Nachweis oder Ausschluss von Komplikationen. In der Abklärung einer Urolithiasis steht die CT als bildgebende Methode der Wahl an erster Stelle. Mit Niedrigdosistechniken lässt sich mit sehr hoher Sensitivität und Spezifität ein Steinnachweis- oder -ausschluss bei vertretbarerer Strahlenbelastung erbringen. Die native Stein-CT gibt zudem grundlegende Informationen, die die weitere Therapieplanung maßgeblich beeinflussen. Die Diagnose von Ureterverletzungen ist klinisch und radiologisch nicht trivial. Hier helfen urographische Kontrastmittelphasen in der Abklärung. In der Diagnostik von traumatischen Harnblasenverletzungen nimmt die (CT-)Zystographie einen hohen Stellenwert ein.

Abstract

Urinary tract infections are the most common infectious diseases in Germany. In most cases clarification does not rely on imaging techniques other than sonography and is made mostly based on clinical symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) can be used in selected cases to find the cause and detection or exclusion of complications, e.g. recurrent or atypical and complicated courses. The method of choice for clarification of urolithiasis is CT. Using low-dose techniques, detection or exclusion of urinary stones can be achieved with a high sensitivity and specificity as well as an acceptable level of radiation exposure. Native stone CT supplies additional fundamental information that can substantially influence further therapy planning. The diagnosis of ureteral injuries is clinically and radiologically not trivial and clarification is aided by urographic contrast media. The method of CT cystography has an important role in the diagnostics of urinary bladder injuries.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Budjan, P. Riffel, M.M. Ong, C. Bolenz, S.O. Schönberg und S. Haneder geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim, Deutschland

    J. Budjan, P. Riffel, M.M. Ong & S.O. Schönberg

  2. Klinik für Urologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland

    C. Bolenz

  3. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinik Köln, Köln, Deutschland

    S. Haneder

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  1. J. Budjan
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Budjan, J., Riffel, P., Ong, M. et al. Infektionskrankheiten und Verletzungen der Harnblase und der ableitenden Harnwege. Radiologe 54, 1111–1124 (2014). https://doi.org/10.1007/s00117-014-2748-x

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  • DOI: https://doi.org/10.1007/s00117-014-2748-x

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