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Методы визуализации околощитовидных желез при первичном гиперпаратиреозе. Обзор литературы

Слащук К. Ю., Дегтярев М. В., Румянцев П. О., Трошина Е. А., Мельниченко Г. А., Рунова Г. Е., Бельцевич Д. Г.
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Слащук Константин Юрьевич - научный сотрудник, ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, slashuk911@gmail.com, 117036, г. Москва, ул. Дм.Ульянова, д.11
Дегтярев Михаил Владимирович - Зав. отделением радионуклидной диагностики ОРНДТ, института Онкоэндокринологии, ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, germed@mail.ru, 117036, г. Москва, ул. Дм.Ульянова, д.11
Румянцев Павел Олегович - доктор медицинских наук, врач-онколог высшей категории, заместитель директора Центра по инновационному развитию, заведующий отделом радионуклидной диагностики и терапии ФГБУ ЭНЦ., ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, pavelrum@gmail.com, 117036, г. Москва, ул. Дмитрия Ульянова, д. 11
Трошина Екатерина Анатольевна - д.м.н., проф., член-корр. РАН, ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, troshina@imbox.ru, 117036, г. Москва, ул. Дм.Ульянова, д.11
Мельниченко Галина Афанасьевна - д.м.н., профессор, академик РАН, ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, teofrast2000@mail.ru, 117036, Москва, ул. Дм. Ульянова, д. 11
Рунова Гюзель Евгеньевна - ФГБОУ ВО ''''Первый московский государственный медицинский университет имени И.М.Сеченова'''', guzelvolkova@yandex.ru,
Бельцевич Дмитрий Германович - доктор медицинских наук, главный научный сотрудник отдела жирургии ФГБУ ЭНЦ, ФГБУ ''''Эндокринологический научный центр'''' Минздрава России, Москва, belts67@gmail.com, 117036, Москва, улица Дмитрия Ульянова, дом 11 -------- 11, Дм.Ульянова стрит, Моссоу, 117036

Первичный гиперпаратиреоз (ПГПТ) – распространенное эндокринное заболевание, часто протекающее без специфичных симптомов, более чем в половине случаев выявляющееся при лабораторном определении кальция и паратиреоидного гормона в крови. Представление о распространенности заболевания, клинической картине и тактике ведения пациентов с гиперпаратиреозом изменилось с момента внедрения рутинного скрининга гиперкальциемии. Успешная диагностика и лечение возможны при участии мультидисциплинарной команды специалистов, среди которых должны быть эндокринолог, эндокринный хирург, врач ультразвуковой диагностики, радиолог, рентгенолог и патоморфолог. Единственный радикальный метод лечения ПГПТ – хирургическое удаление патологически измененных околощитовидных желез, в связи с чем возникает необходимость совершенствования алгоритмов диагностического поиска. Своевременное лечение гиперпаратиреоза позволяет избежать тяжелых поражений костей скелета, почек, сердца, других органов и систем, улучшая качество жизни и снижая частоту инвалидизации пациентов. Для написания систематического литературного обзора было использовано более 100 источников литературы, отбирались статьи, опубликованные с 2000 г. по настоящее время, при помощи следующих ресурсов: PubMed, Embase, SciSearch, Scopus, Cochrane Databases, Research Gate, Google Scholar, в том числе рекомендации Американской ассоциации эндокринологов и эндокринных хирургов (AACE/AAES), Европейского общества ядерной медицины (EANM), Европейского общества эндокринологов (ESE), Российской ассоциации эндокринологов (РАЭ) и ряда других организаций. Основная задача обзора – обобщить и представить актуальную информацию и новый взгляд на дооперационную диагностику, методы интраоперационной навигации, хирургию, контроль качества проводимого лечения у пациентов с ПГПТ.

Ключевые слова:
гиперпаратиреоз, методы визуализации, УЗИ, сцинтиграфия, ОФЭКТ, ОФЭКТ/КТ, МСКТ, МРТ, ПЭТ/КТ, ядерная медицина, эндокринная хирургия, эндокринология, hyperparathyroidism, imaging techniques, ultrasound, scintigraphy, SPECT, SPECT/CT, CT, MRI, PET, PET/CT, nuclear medicine, endocrine surgery, endocrinology

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Imaging methods of the parathyroid glands in primary hyperparathyroidism. Literature review

Slashchuk K. Y., Degtyarev M. V., Rumyantsev P. O., Troshina E. A., Melnichenko G. A.

Primary hyperparathyroidism (PHPT) is a common endocrine disease that occurs with multiple profiles in which no classical manifestation. Diagnosis revolves around routine measurement of serum calcium and parathyroid hormone more than in half cases. The understanding of clinical presentation, epidemiology and management tactics of patients with hyperparathyroidism has significantly changed by virtue of the use of biochemical calcium screening. The successful diagnosis and treatment are possible with the cooperation of a multidisciplinary team of endocrinologist, endocrine surgeon, radiologist, nuclear medicine physician and pathomorphologist. The only radical method of treatment is the surgical removal of abnormal parathyroid glands. In this regard, there is necessary to improve the parathyroid glands imaging algorithms. Early treatment of hyperparathyroidism allows to avoid severe damage to the bones, kidneys, heart, other organs, improving the quality of life and reducing the incidence of disability. For a systematic literature review, more than 100 articles published from 2000 to the present time were used, on following resources: PubMed, Embase, SciSearch, Scopus, Cochrane Databases, Research Gate, Google Scholar. Including recommendations from the American Association of Endocrinologists and Endocrine Surgeons (AACE/AAES), European Society of Nuclear Medicine (EANM), European Society of Endocrinologists (ESE), Russian Association of Endocrinologists (RAE) and several other organizations. The main goal of this review is to summarize and present relevant information and a new look on preoperative imaging techniques, methods of intraoperative navigation, surgery, control quality of treatment in patients with primary hyperparathyroidism.

Keywords:
гиперпаратиреоз, методы визуализации, УЗИ, сцинтиграфия, ОФЭКТ, ОФЭКТ/КТ, МСКТ, МРТ, ПЭТ/КТ, ядерная медицина, эндокринная хирургия, эндокринология, hyperparathyroidism, imaging techniques, ultrasound, scintigraphy, SPECT, SPECT/CT, CT, MRI, PET, PET/CT, nuclear medicine, endocrine surgery, endocrinology

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