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Interventionelle Sonografie am Thorax

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Bildatlas der Lungensonographie

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Zusammenfassung

Neben der häufigen Punktion des Pleuraergusses sind raumfordernde, sonographisch untersuchbare Massen in der Brustwand, im Rippenfell, in der Lunge oder im vorderen Mediastinum eine wichtige Indikation. Die Ursache vieler Erkrankungen der Brustorgane lässt sich durch eine kombinierte Auswertung der Krankengeschichte, der klinischen Befunde und der bildgebenden Diagnoseverfahren ermitteln. Eine aufwändige diagnostische „Kaskade“, die alle verfügbaren Methoden aneinanderreiht, ist weder wirtschaftlich vertretbar noch aus medizinischer Sicht sinnvoll. Für eine definitive Beurteilung ist oft eine zusätzliche biochemische, mikrobiologische, zytologische oder histologische Begutachtung erforderlich. Das für solche Untersuchungen benötigte Material kann durch gezielte Punktion gewonnen werden. Bei entsprechender Indikation können sich an die Punktion auch interventionelle therapeutische Maßnahmen anschließen. Es sollte immer diejenige interventionelle Methode angewendet werden, die am schnellsten und für den Patienten am wenigsten belastend eine sichere Diagnose liefert. Interventionelle Maßnahmen im Bereich des Thorax - verschiedene Verfahren: 1. Perkutaner Zugang 2. Endoluminaler Zugang 3. Chirurgisch.

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  1. Klinikum am Steinenberg, Medizinische Klinik, Akademisches Lehrkrankenhaus der Universität Tübingen, Reutlingen, Deutschland

    Wolfgang Blank

  2. Medizinische Klinik II, St. Josefs-Hospital Wiesbaden GmbH, Wiesbaden, Deutschland

    Thomas Müller

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Blank, W., Müller, T. (2022). Interventionelle Sonografie am Thorax. In: Mathis, G. (eds) Bildatlas der Lungensonographie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62409-8_10

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