medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1206medvis-1308Research ArticleПОЧКИ. Специальная сессия под редакцией профессора А.И. ГромоваKIDNEYS. Special session edited by professor A.I. GromovДоплеровский артефакт мерцания: физические механизмы и место в диагностической практике. Современное состояние вопросаDoppler twinkling artifact: physical mechanisms and place in diagnostic practice. State of the arthttps://orcid.org/0000-0002-9014-9022ГромовА. И.GromovA. I.

Громов Александр Игоревич – доктор мед. наук, профессор, профессор кафедры лучевой диагностики; руководитель группы лучевых методов диагностики и лечения отдела онкоурологии

105425 Москва, 3-я Парковая ул., 51, стр. 1;

127473 Москва, ул. Делегатская, д. 20, стр.1

Alexander I. Gromov – Doct. of Sci. (Med.), Associate Professor; head of the radiation diagnosis and treatment methods, Oncourology Department

51-1, 3rd Parkovaya str., Moscow 105425;20/1, Delegatskaya str., Moscow 127473

gai8@mail.ruhttps://orcid.org/0000-0002-4979-7706СапожниковО. А.SapozhnikovO. A.

Сапожников Олег Анатольевич – доктор физ.-мат. наук, профессор физического факультета МГУ имени М.В. Ломоносова

119991 Москва, Ленинские горы, Российская Федерация;

Seattle, WA, 98105 USA

Oleg A. Sapozhnikov – Doct. of Sci. (Phys.-Math.), Professor at Physics Faculty of M.V. Lomonosov Moscow State University

Leninskie Gory, Moscow 119991, Russian FederationSeattle, WA, 98105 USA

https://orcid.org/0000-0001-8784-8415КапринА. Д.KaprinA. D.

Каприн Андрей Дмитриевич – доктор мед. наук, профессор, академик РАН, заслуженный врач РФ, генеральный директор ФГБУ “НМИЦ радиологии” Минздрава России; директор МНИОИ им. П. А. Герцена – филиал ФГБУ “НМИЦ радиологии” Минздрава России; заведующий кафедрой урологии и оперативной нефрологии с курсом онкоурологии медицинского факультета ФГАОУ ВО “Российский университет дружбы народов”

125284 Москва, 2-й Боткинский проезд, д. 3;125284 Москва, 2-й Боткинский проезд, д. 3; 117198 Москва, ул. Миклухо-Маклая, д. 6

Andrei D. Kaprin – Doct. of Sci. (Med.), Academician of RAS, Professor, general director of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Director of P. Hertsen Moscow oncology research institute; Head of Department of Oncology and Radiology of RUDN University

3, 2nd Botkinsky proezd, Moscow 125284; 6, Miklukho-Maklay str., Moscow 117198 

НИИ урологии и интервенционной радиологии им. Н.А. Лопаткина – филиал ФГБУ “НМИЦ радиологии” Минздрава России; ФГБОУ ВО “Московский государственный медико-стоматологический университет им. А.И. Евдокимова” Минздрава РоссииРоссияN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiologiсal Center of the Ministry of Health of Russian Federation; A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian FederationRussian FederationФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of WashingtonРоссияLomonosov Moscow State University; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of WashingtonRussian FederationФГБУ “Национальный медицинский исследовательский центр радиологии” Минздрава России; МНИОИ им. П. А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; ФГАОУ ВО “Российский университет дружбы народов” Минобрнауки РоссииРоссияNational Medical Research Radiological Centre of the Ministry of Health of the Russian Federation; P. Hertsen Moscow oncology research institute – Branch of National Medical Research Radiological Centre of the Ministry of Healthcare of the Russian Federation; The Peoples' Friendship University of RussiaRussian Federation202328122022271120134Copyright © Громов А.И., Сапожников О.А., Каприн А.Д., 20232023Громов А.И., Сапожников О.А., Каприн А.Д.Gromov A.I., Sapozhnikov O.A., Kaprin A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1308

Введение. Артефакт мерцания известен специалистам ультразвуковой диагностики с 1996 г. Однако до настоящего времени нет однозначного понимания как физических основ его появления, так и областей ультразвуковой диагностики, где выявление его несет реальную диагностическую информацию.Материал и методы. В электронных базах данных (PubMed, E-library, Web of Science) был проведен поиск опубликованных исследований по ключевым словам “twinkling artifact”, “мерцающий артефакт”, “артефакт мерцания”. Систематизирована и проанализирована имеющаяся научная литература, посвященная доплеровскому артефакту мерцания с момента первых публикаций о его существовании. Отмечены собственные разработки на эту тему. Определены современные взгляды на данное явление и его место в ультразвуковой диагностике. Представлена основная на настоящий момент версия о причинах возникновения данного явления.Результаты. Сформулированы рекомендации для практических врачей по изменению настроек ультразвукового сканера с целью повышения выявляемости артефакта мерцания. Определены направления использования артефакта для получения дополнительных диагностических признаков патологических изменений, к которым в настоящее время относят диагностику нефро-, уретеро- и холедохолитиаза.Заключение. Отмечена высокая эффективность использования артефакта мерцания для диагностики мелких камней почек, сопоставимая с возможностями компьютерной томографии. Показана низкая результативность использования артефакта для выявления микрокальцинатов молочной железы и обызвествлений других анатомических структур.

The twinkling artifact has been known to specialists in ultrasound diagnostics since 1996. However, until now there is no understanding of the reasons for its appearance, and the place of its application in diagnostics.

Material and methods

Material and methods. Electronic databases (PubMed, E-library, Web of Science) were searched studies using the keyword – “twinkling artifact”. The scientific publications on the Doppler twinkling artifact from the moment of the first reports about its existence is systematized and analyzed. The authors' own developments on this topic are presented. Modern views on this phenomenon and its place in ultrasound diagnostics are described. An explanation of the physical mechanisms of this phenomenon is given.

Results

Results. Recommendations are formulated for practitioners on changing the settings of an ultrasound scanner in order to increase twinkling artifact detectability. The directions of using the artifact to obtain additional diagnostic signs of pathological changes, which currently include the diagnosis of nephro-, uretero- and choledocholithiasis, are determined.

Conclusions

Conclusions. The high efficiency of the use of the twinkling artifact for the diagnosis of small kidney stones, comparable with the capabilities of computed tomography, has been shown.  

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