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Erschienen in:

03.08.2021 | Computertomografie | Leitthema

Bildgebung bei chronisch obstruktiver Lungenerkrankung und Asthma

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verfasst von: Prof. Dr. med. Julia Ley-Zaporozhan, Prof. Dr. Mark O. Wielpütz

Erschienen in: Zeitschrift für Pneumologie | Ausgabe 5/2021

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Zusammenfassung

Die COPD („chronic obstructive pulmonary disease“) ist eine der führenden Erkrankungen weltweit und eine der 3 häufigsten Todesursachen. Daher ist die Diagnostik von großer Bedeutung. Hieraus ergeben sich verschiedene Phänotypen, die potenziell einer Therapie zugänglich sind. Das am breitesten eingesetzte Verfahren ist die Röntgenaufnahme. Diese zeigt den generalisierten Effekt der Veränderungen. Für eine detaillierte Analyse ist die Computertomographie (CT) allerdings unabdingbar. Hiermit lassen sich verschiedene Phänotypen differenzieren: der Emphysemtyp und der Atemwegstyp. Das Emphysem wiederum lässt sich in verschiedene Unterkategorien einteilen, das zentrilobuläre Emphysem, das destruktive und panlobuläre Emphysem. Basierend auf dieser Klassifikation, ergeben sich verschiedene therapeutische und weitere differenzialdiagnostische Möglichkeiten, z. B. Abklärung eines möglichen α1-Antitrypsin-Mangels. Zudem lassen sich die CT-Aufnahmen quantitativ analysieren, was eine präzisere Verlaufskontrolle ermöglicht. Neben der statischen CT kommt die dynamische CT zum Einsatz, um z. B. eine Tracheobronchomalazie zu detektieren und Lungenareale zu bestimmen, die konstant überbläht sind und nicht am Gasaustausch teilnehmen. Diese Informationen und die Kenntnisse über die Integrität der Lappenspalten sind für die interventionelle Therapieplanung wichtig. Neben diesen etablierten Techniken können weitere funktionelle Methoden, v. a. mittels Magnetresonanztomographie (MRT), eingesetzt werden – dies aber primär zu Forschungszwecken. Bei Asthma fungiert die primäre Indikation zur Bildgebung eher zur Umfelddiagnostik und zum Ausschluss anderer Differenzialdiagnosen wie Herzinsuffizienz oder COPD.
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Metadaten
Titel
Bildgebung bei chronisch obstruktiver Lungenerkrankung und Asthma
Es gibt hier nichts zu sehen?
verfasst von
Prof. Dr. med. Julia Ley-Zaporozhan
Prof. Dr. Mark O. Wielpütz
Publikationsdatum
03.08.2021
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Pneumologie / Ausgabe 5/2021
Print ISSN: 2731-7404
Elektronische ISSN: 2731-7412
DOI
https://doi.org/10.1007/s10405-021-00403-3

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