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Z Gastroenterol 2002; 40(1): 21-32
DOI: 10.1055/s-2002-19633
Aktuelle Sonographie
© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Duplexsonographie der Lebergefäße - eine Übersicht

Doppler Imaging of Hepatic Vessels - ReviewA. Ignee1 , M. Gebel2 , W. F. Caspary1 , Ch F. Dietrich1
  • 1Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Medizinische Klinik II
    (Direktor: Prof. Dr. W. F. Caspary)
  • 2Medizinische Hochschule Hannover, Abt. Gastroenterologie/Hepatologie (Direktor: Prof. Dr. M. Manns)
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Publication History

1.8.2001

18.10.2001

Publication Date:
21 January 2002 (online)

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Zusammenfassung

Die (Farb-)Duplexsonographie hat sich bei Patienten mit arteriellen, portalvenösen und venösen Veränderungen der Lebergefäße etabliert. Im Vordergrund des Indikationsspektrums stehen Erkrankungen mit portaler Hypertension (z. B. zirrhotischer Umbau der Leber, Pfortaderthrombose, Lebervenenverschlusssyndrom) sowie entzündliche und neoplastische Veränderungen. In der Literatur herrscht bisher kein Konsens bezüglich der Untersuchungstechnik (z. B. Messort, Gefäßabschnitt, Einschallwinkel). Die Duplexsonographie der Lebergefäße ist durch die nur eingeschränkt reproduzierbare Erfassung von absoluten Geschwindigkeiten (maximale systolische Geschwindigkeit, enddiastolische Geschwindigkeit, mittlere Geschwindigkeit) und durch ungünstige Untersuchungsbedingungen und Einschallwinkel > 60o limitiert. Bei der Berechnung des Blutflussvolumens können zusätzliche Abweichungen durch einen variablen Gefäßquerschnitt entstehen. Die Analyse von Frequenzspektren nichtlaminarer Blutflüsse kann zu Fehlinterpretationen führen. Die in der Literatur angegebenen Normwerte zeigen deswegen eine große Streuung und sind selten miteinander vergleichbar. In dieser Übersicht werden die in der Literatur angegebenen Untersuchungsmethoden zusammengefasst, analysiert und Vorschläge für eine multizentrische Evaluierung duplexsonographischer Normwerte der Lebergefäße formuliert.

Abstract

Hepatic blood flow has been investigated using color Doppler ultrasonography in patients with liver disease, especially in patients with portal hypertension (e. g. liver cirrhosis, portal vein thrombosis, Budd-Chiari-syndrome).

Duplex examination protocols, however, differ considerably because no standard technique has been established so far. Whereas there is an agreement about the angle of the ultrasound application (< 60 °), neither the exact location nor the relevant examination parameters have been standardized. Based on a search of the relevant literature, published examination techniques and results were analyzed. These findings are to serve as a basis for a prospective multicenter study for the determination of standard values.

Schlüsselwörter

Arteria Hepatica - Pfortader - Lebervenen - Portale Hypertension - Doppler-Perfusionsindex

Key words

Hepatic Artery - Portal Vein - Hepatic Vein - Portal Hypertension - Doppler-Perfusion-Index

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PD Dr. med. C. F. Dietrich

Medizinische Klinik II, Haus 11
Klinikum der Johann-Wolfgang-Goethe-Universität

Theodor-Stern-Kai 7

60590 Frankfurt a. M.

Email: c.f.dietrich@em.uni-frankfurt.de