Zusammenfassung
Ziel: Beurteilung einer umfassenden internistischen Ultraschalluntersuchung im Vergleich zur Ganzkörper-MRT hinsichtlich kardiovaskulärer Risikofaktoren, metabolischem Syndrom, maligner Tumoren und anderer therapeutisch relevanter Befunde.
Material und Methoden: 833 konsekutive Patienten (19 – 93 J., m 56,6 J.) erhielten Sonografie (hirnzuführende Gefäße, Schilddrüse, Abdomen und Herz) und MRT-Untersuchung (Ganzkörper-MR-Angiografie, MRT Kopf, Thorax, Abdomen, virtuelle Koloskopie). Die Analyse erfolgte retrospektiv anhand der schriftlichen Befunde.
Ergebnisse: In der Detektion früher arteriosklerotischer Veränderungen (Intima-media-Verdickung, nicht stenosierende Plaques, 33 % der Pat.) sowie der Steatosis hepatis als wichtiger Parameter des metabolischen Syndroms (20,4 %) war die Sonografie der MRT deutlich überlegen. Maligne Tumoren waren selten (1,4 %) und meist im Abdomen gelegen. MRT und Sonografie waren gleichwertig in der Detektion der abdominellen Tumoren und kleiner Leberherde. Ausschließlich im MRT darstellbar waren intrakranielle Befunde, maligne intrathorakale Befunde sowie Kolonpolypen.
Schlussfolgerung: Hinsichtlich der Detektion früher Arteriosklerose sowie des metabolischen Syndroms erwies sich die Sonografie überlegen. In der Darstellung tumoröser Veränderungen des Bauchraums waren die Methoden gleichwertig. Die Ganzkörper-MRT mit virtueller Koloskopie entdeckt zusätzlich krankhafte Veränderungen des Gehirns, des Thoraxraums sowie Kolonpolypen.
Abstract
Purpose: The benefit of ultrasound in comparison with full-body MRI during a medical checkup in preventive health care was examined with regard to the detection of cardiovascular risk factors, metabolic syndrome, malignant tumors and further relevant findings.
Materials and Methods: 833 consecutive patients (266 f/567 m, age: 19 – 93 y, mean age: 56.6 y) underwent both ultrasound (extracranial carotid arteries, thyroid, abdominal ultrasound and echocardiography) and whole-body MRI (whole-body MR angiography, head, thorax, abdomen and virtual colonoscopy). For ultrasound examinations, DEGUM level III devices were used (Siemens Acuson Antares, Siemens G60, Siemens, Erlangen). MRI examinations were performed using a 1.5 Tesla MRI device (Siemens Avanto, Siemens, Erlangen). All patients were reviewed retrospectively based on the written reports.
Results: Ultrasound was much more sensitive in detecting early atherosclerotic changes than MRI angiography. In 33 % of the patients, manifestations of atherosclerosis were found. Thoracic (3) and abdominal aortic and mesenteric artery aneurysms (3) were diagnosed by both methods. Hepatic steatosis as an important risk factor of metabolic syndrome was only found by ultrasound in 20.4 % of our patients. Malignant tumors were rare in this population (1.4 %): all abdominal tumors except one renal oncocytoma were found using both methods. MRI and ultrasound were equally sensitive with respect to the detection of small liver foci. As expected, MRI was less sensitive than ultrasound in the diagnosis of thyroid nodes. For intracranial diagnoses, malignant intrathoracic findings and colonic polyps, ultrasound is not the method of choice.
Conclusion: For the detection of lifestyle-dependent diseases such as atherosclerosis and metabolic syndrome, ultrasound examination was more sensitive than MRI, and the same was true for the early detection of thyroid diseases. For the detection of malignant abdominal tumors, both methods were equally sensitive. Whole-body MRI can additionally detect pathological changes in the head, lungs and colon.
Key words
arteriosclerosis - metabolic disorders - screening - MR imaging - 2 D ultrasound
