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Pleura

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Bildatlas der Lungen- und Pleurasonographie

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Zusammenfassung

Nach der Thoraxwand ist die Pleura die sonographisch am leichtesten erreichbare und darstellbare Struktur am Thorax. Durch geeignete Untersuchungstechnik lässt sich die gesamte Pleura costalis und Pleura diaphragmatica erfassen. Die hinter Rippen verborgene viszerale Pleura ist durch Atemmanöver in Interkostalräume verschiebbar. Von jugulär her ist auch das obere vordere Mediastinum mit seinen Pleuraanteilen darstellbar. Die unteren und hinteren mediastinalen und die paravertebralen Pleuraabschnitte sind sonographisch transthorakal meist nicht zu erreichen. Nach Schätzungen anhand computertomographischer Transversalschnitte des Thorax kann man mindestens 60–70% der Pleurafläche sonographisch darstellen (Reuß 1996). Die meisten Erkrankungen der Pleura betreffen vornehmlich die kostalen und diaphragmalen Pleuraabschnitte und die Lungenspitzen. Der Wert der Farbduplexsonographie der Pleura ist zwar noch nicht ausreichend evaluiert, aber Farbduplexsonographie, Spektraldopplersonographie und kontrastverstärkte Sonographie erobern sich einen Platz bei der Differenzialdiagnose von Raumforderungen auf Pleuraniveau.

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  1. Klinikum Sindelfingen/Böblingen, Kliniken Böblingen, Bunsenstraß e 120, 71032, Böblingen, Deutschland

    OA Dr. Joachim Reuß (Leitender Oberarzt der Medizinische Klinik IV Gastroenterologie/Onkologie)

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  1. Internistische Praxis, Bahnhofstr. 16, 6830, Rankweil, Österreich

    Gebhard Mathis

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Reuß, J. (2010). Pleura. In: Mathis, G. (eds) Bildatlas der Lungen- und Pleurasonographie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03567-8_3

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