Медицинская литература. Новинки

 

 

 

 

 

 

Современные методы визуализации подагрических тофусов

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Цель исследования: представить роль обзорной рентгенографии, ультразвуковое исследование (УЗИ), магнитно-резонансной томографии (МРТ), рутинной и двухэнергетической компьютерной томографии (ДЭКТ), а также остеосцинтиграфии в диагностике подагрического артрита. Материал и методы. Анализ литературных источников выполнялся в информационно-аналитических системах PubMed и Google Scholar за 2012–2023 гг. с использованием следующих ключевых слов: подагрический артрит, подагрический тофус, imaging of gout, X-ray study, ultrasound, CT, dual-energy CT, MRI, bone scintigraphy, PET/CT.Результаты. Проанализировано 894 статьи, 39 из которых использованы для составления обзора. Дополнительно использованы 42 статьи за 2018–2023 гг. и клинические рекомендации. Результаты поиска: статьи сгруппированы в блоки на основании лучевых модальностей, систематизирована визуальная картина и роль каждой модальности в ранней диагностике подагрического артрита.Заключение. Несмотря на то что “золотым стандартом” диагностики подагрического артрита является исследование синовиальной жидкости, основная роль в выявлении данного заболевания отводится лучевой диагностике.Современные диагностические модальности – УЗИ, МРТ и ДЭКТ открывают новые возможности в выявлении подагры без необходимости инвазивной процедуры пункции сустава. Наибольшей диагностической информативностью обладают УЗИ и ДЭКТ, включенные в классификационные критерии ACR и EULAR.ДЭКТ опережает в сравнительном аспекте другие лучевые модальности, при этом обеспечивает визуализацию кристаллов Моноурата натрия и их количественную оценку.Результаты исследований, оценивающих чувствительность и специфичность современных методов визуализации, позволяют говорить о возможности адекватной и своевременной диагностике подагры. В то же время необходимо учитывать проблемы и ограничения используемых диагностических модальностей, что создают основу для дальнейших исследований в этом направлении.

Ключевые слова:
подагрический артрит, подагрический тофус, imaging of gout, X-ray study, ultrasound, CT, dual-energy CT, MRI, bone scintigraphy, PET/CT, Gout, tophus, gout diagnostics, CT, MRI, DECT, ultrasound, X-ray, nuclear medicine.

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Modern methods of visualization of gouty tophi

Objective: to present modern methods of visualization of gouty tophi.Materials and methods. A search was made for scientific publications and clinical recommendations in the PubMed and Google Scholar information and analytical systems for 2007-2022, using the following words: diagnosis of gout, X-ray gout, gout ultrasound, gout CT, gout DECT, gout MRI, gout scintigraphy.Results. 894 articles were analyzed, 42 of which were used to compile the review. Search results - blocks of articles were created, within which the articles were analyzed to study diagnostic features.Conclusion. Early diagnosis and the choice of the correct tactics for the treatment of gouty tophi remain extremely relevant and require additional attention from diagnostic doctors and clinicians.

Keywords:
подагрический артрит, подагрический тофус, imaging of gout, X-ray study, ultrasound, CT, dual-energy CT, MRI, bone scintigraphy, PET/CT, Gout, tophus, gout diagnostics, CT, MRI, DECT, ultrasound, X-ray, nuclear medicine.