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MRT der Leber

Klinische Bedeutung nichtspezifischer und leberspezifischer MRT-Kontrastmittel

Diagnosis of liver diseases part 1: MRI of the liver

Clinical significance of nonspecific and liver-specific MRI contrast agents

  • Leberdiagnostik Teil 1
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Zusammenfassung

In der Leber treten häufig benigne und maligne fokale Läsionen auf. Viele der gutartigen Veränderungen, wie simple Zysten, Hämangiome, fokal noduläre Hyperplasien (FNH) und Adenome, sind Zufallsbefunde. Ihre richtige Diagnose ist v. a. bei Patienten mit malignen Erkrankungen wichtig. Initiale Untersuchungsmethoden bei Leberläsionen sind meist Ultraschall oder CT. Die MRT nimmt aufgrund des hohen Weichteilkontrastes und der besseren Verfügbarkeit eine wichtige Rolle in der Abklärung von Lebertumoren ein. MRT-Kontrastmittel erhöhen die Aussagekraft gegenüber nativen Pulssequenzen. Zwischenzeitlich sind 3 Klassen für die Leberdiagnostik zugelassen: nichtspezifische extrazelluläre, hepatobiliäre und superparamagnetische Kupffer-Zell-Kontrastmittel. In der vorliegenden Arbeit werden die häufigsten fokalen Leberläsionen, deren diagnostische Möglichkeiten und Untersuchungsprotokolle beschrieben. Durch Einsatz spezifischer Leberkontrastmittel zur Detektion und Differenzialdiagnose fokaler Läsionen können häufig Biopsien zur Charakterisierung der Leberläsionen vermieden werden.

Abstract

The liver is a common site for various benign and malignant focal lesions. The initial modality for assessing liver lesions is ultrasound or CT. MRI with its superior soft tissue contrast offers multiple advantages over other imaging modalities. Contrast agents have been developed that increase the detection rate and provide more specific information in comparison to unenhanced techniques. In the mean time three classes are available for MR imaging of the liver: extracellular gadolinium chelates, hepatobiliary and reticulo-endothelia, superparamagnetic agents. We describe in this review the most common focal lesions, their diagnostic possibilities, and the imaging protocols. Clinical use of these contrast agents facilitates detection and differential diagnosis of focal liver lesions that may help to avoid invasive procedures such as biopsy for lesion characterization.

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Authors and Affiliations

  1. Universitätsklinik für Radiodiagnostik, Medizinische Universität , Wien

    A. Ba-Ssalamah, B. Happel, J. Kettenbach, A. Dirisamer & W. Schima

  2. Universitätsklinik für klinische Pathologie, Medizinische Universität , Wien

    F. Wrba

  3. Universitätsklinik für Allgemeinchirurgie, Medizinische Universität , Wien

    F. Längle

  4. Universitätsklinik für Radiodiagnostik, Medizinische Universität, Währinger Gürtel 18–20, 1090 , Wien, Österreich

    A. Ba-Ssalamah

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  1. A. Ba-Ssalamah
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  2. B. Happel
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  3. J. Kettenbach
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  7. W. Schima
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Correspondence to A. Ba-Ssalamah.

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Ba-Ssalamah, A., Happel, B., Kettenbach, J. et al. MRT der Leber. Radiologe 44, 1170–1184 (2004). https://doi.org/10.1007/s00117-004-1142-5

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  • DOI: https://doi.org/10.1007/s00117-004-1142-5

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