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Funktionelle MR-Tomographie der Leber

Functional MR imaging of the liver

  • Leitthema
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Zusammenfassung

Die Diagnostik diffuser Lebererkrankungen stützt sich klassisch auf die Leberbiopsie und deren histopathologische Analyse. Dieses Verfahren ist allerdings für die Patienten unangenehm und schmerzhaft, birgt v. a. bei Patienten mit Lebererkrankungen ein gewisses Risiko und eignet sich daher nur sehr eingeschränkt zur Verlaufskontrolle bei chronischen Erkrankungen. Die Magnetresonanztomographie (MRT) der Leber nimmt schon jetzt eine zentrale Stellung in der Diagnostik von Raumforderungen der Leber und von Erkrankungen der Gallenwege ein. Darüber hinaus bietet dieses nichtinvasive Verfahren Möglichkeiten, diffuse Erkrankungen des Leberparenchyms zu diagnostizieren und ihren Schweregrad abzuschätzen, z. B. bei nichtalkoholischer Leberverfettung, Hepatitis, Leberfibrose, Zirrhose, Hämochromatose und Siderose und anderen. Folgen einer parenchymatösen Lebererkrankung, wie die portale Hypertension oder eine eingeschränkte Organfunktion, können mithilfe spezieller MRT-Techniken entdeckt und quantifiziert werden. Die vorliegende Arbeit bietet einen Überblick über die dabei angewendeten Methoden und diskutiert die Wertigkeit der funktionellen Leber-MRT im klinischen Zusammenhang.

Abstract

The diagnostics of diffuse liver disease traditionally rely on liver biopsies and histopathological analysis of tissue specimens. However, a liver biopsy is invasive and carries some non-negligible risks, especially for patients with decreased liver function and those requiring repeated follow-up examinations. Over the last decades, magnetic resonance imaging (MRI) has developed into a valuable tool for the non-invasive characterization of focal liver lesions and diseases of the bile ducts. Recently, several MRI methods have been developed and clinically evaluated that also allow the diagnostics and staging of diffuse liver diseases, e. g. non-alcoholic fatty liver disease, hepatitis, hepatic fibrosis, liver cirrhosis, hemochromatosis and hemosiderosis. The sequelae of diffuse liver diseases, such as a decreased liver functional reserve or portal hypertension, can also be detected and quantified by modern MRI methods. This article provides the reader with the basic principles of functional MRI of the liver and discusses the importance in a clinical context.

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Authors and Affiliations

  1. Universitätsklinik für Radiodiagnostik und Nuklearmedizin, Medizinische Universität Wien, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    A. Wibmer, R. Nolz & A. Ba-Ssalamah

  2. Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Wien, Wien, Österreich

    M. Trauner

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  1. A. Wibmer
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  2. R. Nolz
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  3. M. Trauner
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  4. A. Ba-Ssalamah
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Correspondence to A. Wibmer.

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A. Wibmer, R. Nolz, M. Trauner und A. Ba-Ssalamah geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Wibmer, A., Nolz, R., Trauner, M. et al. Funktionelle MR-Tomographie der Leber. Radiologe 55, 1057–1066 (2015). https://doi.org/10.1007/s00117-015-0032-3

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