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Endobronchiale Sonographie

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Zusammenfassung

Der Blick des Endoskopikers ist auf das Lumen und die innere Oberfläche der Atemwege beschränkt. Prozesse, die sich in den verschiedenen Wandschichten ausbreiten oder die außerhalb des Lumens den Atemwegen anliegen, können nur an indirekten Zeichen vermutet werden. Ein großer Teil pathologischer Prozesse an den Atemwegen erfasst auch die parabronchialen Strukturen. Besonders bei malignen Prozessen ist das für das spätere Schicksal des Patienten entscheidend, und es besteht deshalb ein dringender Bedarf, den Blick über die Tracheobronchialwand hinaus zu erweitern (Becker 1995). Die externe mediastinale Sonographie erreicht die tiefe paratracheale und perihiläre Region kaum. Mit der transösophagealen Sonographie lassen sich die prätrachealen und hilären Strukturen wegen der dazwischen liegenden Atemwege oder dem fehlenden anatomischen Kontakt kaum einsehen (Shannon et al. 1996). Deshalb haben wir seit 1989 begonnen, den endobronchialen Ultraschall zu erproben (◘ Abb. 6.1a–c)
◘ Abb. 6.1a–c.

Ausschluss der Wandinfiltration. (TU Tumor, LN Lymphknoten, AOA Aorta ascendens, TR Trachea, ES Endosonde, In kleiner Lymphknoten, VC V. cava)

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Copyright information

© Springer Medizin Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Innere Medizin/PulmonologieThoraxklinik Heidelberg gGmbHHeidelbergDeutschland

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