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Radiologische Diagnostik bei Lebertumoren

Radiological diagnostic workup of liver tumors

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Zusammenfassung

Die Abklärung fokaler Leberläsionen gehört zu den wesentlichen Aufgaben im radiologischen Alltag. Ziele der bildgebenden Diagnostik sind neben der Läsionsdetektion die Charakterisierung der Läsion sowie die Verlaufsbeurteilung nach chirurgischer oder lokaler Behandlung bzw. unter systemischer Therapie. Dieser Beitrag stellt die typische computer- und magnetresonanztomographische Morphologie hepatozellulärer Karzinome und intrahepatischer cholangiozellulärer Karzinome als wichtigste Vertreter primärer maligner Lebertumoren vor und stellt ihnen benigne primäre Leberläsionen wie das Adenom und die fokale noduläre Hyperplasie (FNH) gegenüber. Daneben werden relevante technische Aspekte der Bildgebung kurz zusammengefasst. Schließlich erfolgt die Vorstellung der Haupt- und Zusatzkriterien der Liver-Imaging-Reporting-and-Data-System(LI-RADS®)-Klassifikation, die für die Beurteilung von Leberläsionen in der Zirrhoseleber zunehmend klinisch etabliert werden.

Abstract

The imaging of focal liver lesions is a common task in daily radiological routine. The objectives of diagnostic imaging are, in addition to lesion detection, the characterization of the lesion as well as the follow-up assessment after surgical or local treatment or under systemic therapy. This article presents the typical morphologies observed in computed tomography and magnetic resonance imaging of hepatocellular carcinomas and intrahepatic cholangiocarcinomas as the most important representatives of primary malignant liver tumors and juxtaposes them with benign primary liver lesions such as adenoma and focal nodular hyperplasia (FNH). In addition, relevant technical aspects of imaging are briefly summarized. Finally, the main and additional criteria of the Liver Imaging Reporting and Data System (LI-RADS®) classification, which are becoming increasingly established clinically for the evaluation of liver lesions in the cirrhotic liver, are presented.

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Author information

Correspondence to Prof. Dr. med. H.-J. Raatschen.

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Interessenkonflikt

H.-J. Raatschen gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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M. Manns, Hannover

T. Wirth, Hannover

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Raatschen, H. Radiologische Diagnostik bei Lebertumoren. Internist (2020). https://doi.org/10.1007/s00108-019-00724-9

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Schlüsselwörter

  • Hepatozelluläres Karzinom
  • Intrahepatisches cholangiozelluläres Karzinom
  • Hepatozelluläres Adenom
  • Fokale noduläre Hyperplasie
  • Leberzirrhose

Keywords

  • Carcinoma, hepatocellular
  • Cholangiocellular carcinoma, intrahepatic
  • Adenoma, liver cell
  • Focal nodular hyperplasia
  • Liver cirrhosis