zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2024-21-2-03zdor-2631Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESНерешенные вопросы применения методов ультразвуковой эластографии у пациентов с мононевропатией пояса нижней конечности и свободной части нижней конечностиUnresolved issues of using ultrasound elastography methods in patients with mononeuropathy of the lower limb girdle and free part of the lower limbhttps://orcid.org/0000-0003-0808-183XЮрковскийА. М.YurkovskiyА. М.

Юрковский Алексей Михайлович, д.м.н., доцент, заведующий кафедрой лучевой диагностики, лучевой терапии с курсом ФПКиП

г. Гомель

Alexei M. Yurkovskiy, Doctor of Medical Sciences, Head of the Department of Radiation Diagnostics, Radiation Therapy with the course of Advanced Training and Retraining

Gomel 

yurkovsky@mail.ruhttps://orcid.org/0000-0002-7496-545XПисьменниковаЕ. И.PismennikovaE. I.

Письменникова Евгения Игоревна, ассистент кафедры лучевой диагностики, лучевой терапии с курсом ФПКиП 

г. Гомель

Evgenia I. Pismennikova, Assistant Lecturer at the department of Radiation Diagnostics, Radiation Therapy with the course of Advanced Training and Retraining

Gomel 

pismennikova.gsmu@gmail.comГомельский государственный медицинский университетGomel State Medical University2024270520242122329Copyright © Юрковский А.М., Письменникова Е.И., 20242024Юрковский А.М., Письменникова Е.И.Yurkovskiy А.М., Pismennikova E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2631Цель исследования

Цель исследования. Систематизировать данные и проанализировать диагностическую эффективность ультразвуковой эластографии при мононевропатиях пояса нижней конечности и свободной части нижней конечности.

Материалы и методы

Материалы и методы. Проведен анализ публикаций в системах PubMed, EMBASE и Web of Science. Основным источником информации служили полнотекстовые научные публикации за период 2013–2023 гг., описывающие случаи применения методов визуализации у пациентов с мононевропатией пояса нижней конечности и свободной части нижней конечности. Основным критерием отбора было наличие в публикации данных о результатах эластографического исследования периферических нервов у пациентов с периферическими нейропатиями и у пациентов без данной патологии. Всего было отобрано ٢٣ оригинальные публикации (в том числе три систематических обзора и одно описание проведенного мета-анализа).

Результаты

Результаты. Определены наиболее перспективные (для имплементации в широкую клиническую практику) методики ультразвуковой эластографии, применение которых способно в случае доработки обеспечить раннюю диагностику мононевропатий пояса нижней конечности и свободной части нижней конечности.

Заключение

Заключение. Применение ультразвуковой эластографии для диагностики мононевропатий пояса нижней конечности и свободной части нижней конечности сдерживается отсутствием четких представлений относительно референсных значений индексов жесткости (кПа, м/с) для конкретных периферических нервов и возможного влияния на указанные индексы жесткости артефактов от костей и других сопредельных тканей. Кроме того, отсутствует четкий алгоритм выбора методики ультразвуковой эластографии в зависимости от локализации и поперечного сечения нерва. Решение указанных проблем позволит оптимизировать применение ультразвуковой эластографии для диагностики мононевропатий пояса нижней конечности и свободной части нижней конечности.

      

      

Objective

Objective. Systematization of data and analysis of the diagnostic effectiveness of ultrasound elastography for mononeuropathies of the lower limb girdle and free part of the lower limb.

Materials and methods

Materials and methods. Publications in the PubMed, EMBASE and Web of Science systems were analysed thoroughly, describing cases of the use of imaging methods in patients with mononeuropathy of the lower limb girdle and free part of the lower limb.

Results

Results. The most promising for implementation in wide clinical practice ultrasound elastography techniques have been identified. The use of them can, if refined, provide early diagnosis of mononeuropathies of the lower limb girdle and the free part of the lower limb.

Conclusion

Conclusion. The use of ultrasound elastography for the diagnosis of mononeuropathy of the lower limb girdle and free part of the lower limb is hampered by the lack of clear ideas regarding the reference values of stiffness indices (kPa, m/s) for specific peripheral nerves and the possible influence of artifacts from bones and other adjacent tissues on these stiffness indices. In addition, there is no clear algorithm for choosing an ultrasound elastography technique, depending on the location and cross-section of the nerve. Solving these issues will allow optimizing the use of ultrasound elastography for the diagnosis of mononeuropathies of the lower limb girdle and the free part of the lower limb.

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The authors declare that there are no conflicts of interest present.