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Computertomographie versus Magnetresonanztomographie

Pro und Kontra in der axialen Spondyloarthritis

Computed tomography versus magnetic resonance imaging

Pros and cons in axial spondyloarthritis

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Zusammenfassung

Die Diagnose der axialen Spondyloarthritis hängt neben der klinischen Einschätzung und der Bestimmung des Histokompatibilitätsantigens HLA-B27 von der direkten Darstellung der Sakroiliitis ab. Während der Wert der konventionellen Röntgenaufnahme mittlerweile in vielen Studien als unzureichend beschrieben wurde, um die Erkrankung früh diagnostizieren zu können, bieten sich nun die Magnetresonanztomographie, aber auch die Computertomographie an, um Befunde wie Knochenmarködeme, Erosionen, Fettmetaplasie, Backfill und Ankylosen darzustellen. Es gilt also zu entscheiden, welches Verfahren wann angewandt werden sollte. Ferner sind beide Schnittbildverfahren aktuell einem starken Wandel unterlegen, und die technische Weiterentwicklung macht jedes Jahr große Schritte. Hier soll ein Überblick gegeben werden, welche Zukunftstechnologien in die rheumatologische Diagnostik der Sakroiliakalgelenke einziehen werden. Diese Übersicht veranschaulicht auch, welche Standardmethoden in der Diagnostik der axialen Spondyloarthritis etabliert sind und wie sie genutzt werden.

Abstract

The diagnosis of axial spondyloarthritis depends on direct visualization of the sacroiliitis in addition to clinical assessment and determination of the histocompatibility antigen HLA-B27. While the value of conventional radiographic images has meanwhile been described in many studies as insufficient to diagnose the disease at an early stage, magnetic resonance imaging and also computed tomography now offer the possibility to visualize findings, such as bone marrow edema, erosion, fat metaplasia, backfill and ankylosis. Thus, it is necessary to decide which procedure should be used and when. Furthermore, both cross-sectional imaging techniques are currently undergoing major changes, and technical advancements are making great strides every year. This article provides an overview of which future technologies will be included in the rheumatological diagnostics of the sacroiliac joints. This overview also illustrates which standard methods are established in the diagnostics of axial spondyloarthritis and how they are used.

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Authors and Affiliations

  1. Klinik für Radiologie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    Kay Geert A. Hermann & Torsten Diekhoff

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  1. Kay Geert A. Hermann
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Correspondence to Kay Geert A. Hermann.

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Interessenkonflikt

K.G.A. Hermann und T. Diekhoff geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor.

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Hermann, K.G.A., Diekhoff, T. Computertomographie versus Magnetresonanztomographie. Z Rheumatol 82, 638–645 (2023). https://doi.org/10.1007/s00393-023-01415-5

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