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Erschienen in: Notfall +  Rettungsmedizin 3/2015

01.05.2015 | Originalien

Relevante Nebenbefunde im CT

Ein unterschätzter Aspekt der modernen Lungenemboliediagnostik

verfasst von: PD Dr. J. Grüttner, T. Viergutz, M. Bolte, T. Henzler, S. Sudarski, T. Walter

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 3/2015

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Zusammenfassung

Hintergrund

Die sichere Erkennung einer Lungenembolie (LE) gilt für Notfalleinrichtungen seit langer Zeit als großes Problem. Die 2008 implementierten und 2014 aktualisierten ESC-Leitlinien zur LE empfehlen ein Vorgehen, welches eine niederschwellige CT-Indikation mit einem hohen Anteil von LE-Ausschlussuntersuchungen vorsieht.

Methoden

Die vorliegende Arbeit untersucht retrospektiv bei 492 Patienten mit Verdacht auf LE die Inzidenz und klinische Bedeutung von Nebenbefunden im CT. Diese könnten – in Ergänzung zur LE-Diagnostik – einen wichtigen zusätzlichen Informationsgewinn bedeuten.

Ergebnisse

Bei 59 Patienten (12 %) wurde eine LE nachgewiesen. In 203 Fällen (41 %) fanden sich Nebenbefunde. Besonders häufig waren die Befunde Struma, Pleuraerguss, pneumonieverdächtiges Infiltrat, neoplasieverdächtige Raumforderung und Lymphknotenvergrößerung; seltener vertreten waren die Befunde pulmonalvenöse Stauung, Perikarderguss, Rippenfraktur und Pneumothorax.

Schlussfolgerung

Die Daten zeigen einen hohen Prozentsatz an Nebenbefunden. Die dargestellten Erkrankungen sind unterschiedlich prognostisch bedeutsam und wären teilweise durch alternative Methoden darstellbar gewesen. Dennoch ist ein Teil der CT-Nebenbefunde mit einem wesentlichen Informationsgewinn und der Notwendigkeit weiterer Nachfolgeuntersuchungen verbunden.
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Metadaten
Titel
Relevante Nebenbefunde im CT
Ein unterschätzter Aspekt der modernen Lungenemboliediagnostik
verfasst von
PD Dr. J. Grüttner
T. Viergutz
M. Bolte
T. Henzler
S. Sudarski
T. Walter
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 3/2015
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-015-0005-0