Relevance. The issue of diagnosing and treating of radiation lesions in the salivary glands remains relevant due to the widespread use of radioiodine therapy for highly differentiated thyroid cancer. Sialoscintigraphy with 99mTc-pertechnetate is the most informative method for assessing salivary gland function. There have been few articles on the use of sialoscintigraphy, and it is yet debatable how the clinical, morphological, and functional characteristics of salivary glands exposed to radioiodine therapy relate to one another. The aim of the research was to study the extent and nature of functional disorders of the major salivary glands that occurred in patients after radioiodine therapy for thyroid carcinoma by using sialoscintigraphy with the radiopharmaceutical 99mTc-pertechnetate, as well as the factors affecting the severity of the related disorders. Materials and Methods. Dynamic sialoscintigraphy with 99mTc-pertechnetate [99mTcO4 – ] was used to study the salivary gland function in 30 patients with papillary thyroid carcinoma who developed chronic radiation sialadenitis after total thyroidectomy and radioactive iodine therapy. The findings of the investigations were compared to clinical data. Results and Discussion. Based on sialoscintigraphiic data, substantial abnormalities of the secretory, excretory, and concentration functions of the major salivary glands were found in patients with clinical signs of chronic radiation sialadenitis. The impairments had considerable individual and topographic variability. In most cases, the salivary glands were affected unevenly: against the background of a decrease in or total loss of function of one or more of them, compensatory changes occurred in other glands. Decompensation signs, as evidenced by diminished secretion and concentration capacity, were greater with the decreased excretion ratio (50.0±4.6% of patients) than with the reduced secretory activity ratio (30.0±4.2%) or the concentration ratio (20.8±3.7% of patients). The excretory function of the salivary glands was most negatively impacted; the median value of the excretion ratio was 0.690 (0–0.855 as opposed to the normal range of 0.99–1.02). The median value of the secretion ratio decreased to 1.015 (0.630–1.2 versus the normal range of 1.21–1.26). The nature and severity of the change in sialoscintigraphy indices were not affected by the underlying illness stage or the 131I dose used. Conclusions. Radiation sialoadenitis developing in thyroid cancer patients who undergo thyroidectomy and radioiodine therapy causes persistent functional impairments with significant clinical manifestations. Dynamic sialoscintigraphy with 99mTc-pertechnetate allows objectifying the nature of these functional abnormalities, selecting the optimal therapeutic program, and evaluating the effective of treatment.

Реноваскулярна хвороба. Сучасний підхід до діагностики та лікування У представленому огляді розглянуто питання етіології та патогенезу реноваскулярної хвороби, її клінічні вияви та підходи до діагностики. Проаналізовано основні неінвазивні діагностичні методи: функціональні тести та діагностичні зображення. Велику увагу приділено методам ультразвукової діагностики, розглянуто значення комп'ютерно-томографічної та магнітно-резонансної ангіографії в діагностиці реноваскулярної хвороби, їх переваги та недоліки, показання і перспективи застосування. Визначено проблеми й ускладнення при проведенні цих досліджень та шляхи запобігання їм. Наведено і проаналізовано дані літератури щодо інформативності різних діагностичних методів, їх впливу на вибір лікувальної тактики та подальшу ефективність лікування, зокрема для визначення показань до реваскуляризації ниркових артерій. Ключові слова: реноваскулярна хвороба, дуплексна допплерівська ультрасонографія, магнітно-резонансна ангіографія, комп'ютерно-томографічна ангіографія, реваскуляризація ниркових артерій.

Äåðaeàâíà óñòàíîâà "²íñòèòóò ñåðöÿ ̳í³ñòåðñòâà îõîðîíè çäîðîâ'ÿ Óêðà¿íè" 2 Äåðaeàâíà óñòàíîâà "²íñòèòóò åíäîêðèíîëî´³¿ òà îáì³íó ðå÷îâèí ³ì. Â.Ï. Êîì³ñàðåíêà Íàö³îíàëüíî¿ àêàäå쳿 ìåäè÷íèõ íàóê Óêðà¿íè" Ðåôåðàò Ìåòà. Âèâ÷åííÿ ìîaeëèâîñòåé ñöèíòè´ðàô³¿ ç 99m Tc-MIBI äëÿ ïåðåäîïåðàö³éíî¿ â³çóàë³çàö³¿ ïàòîëî´³÷íî çì³íåíèõ ïðèùèòîïîä³áíèõ çàëîç òà ïåðåâàãè òåõíî-ëî´³¿ ÎÔÅÊÒ/ÊÒ ïðè ¿õ åêòîﳿ. Ìàòåð³àë ³ ìåòîäè. Îáñòåaeåíî 682 ïàö³ºíòà ç ïà-òîëî´³ºþ ïðèùèòîïîä³áíèõ çàëîç, ç íèõ ae³íêè-619 (90,8%), ÷îëîâ³êè-63 (9,2%). ²ç ïåðâèííèì ã³ïåðïàðàòèðåîçîì áóëî îáñòåaeåíî 549 (80,5%) ïàö³ºíò³â, ç âòîðèííèì/òðåòèííèì ã³ïåðïàðàòèðåîçîì-133 (19,5%) õâîðèõ. Ðåçóëüòàòè é îáãîâîðåííÿ. Ó 490 ïàö³ºíò³â (71,9%) áóëè îòðèìàí³ ä³à´íîñòè÷í³ çîáðàaeåííÿ âèñîêî¿ ÿêîñ-ò³, ç íèõ ó 50 (7,3%) õâîðèõ âèçíà÷àëîñü ìóëüòèãëàíäóëÿðíå óðàaeåííÿ Ó 52 (7,6%) õâîðèõ áóëè âèÿâëåí³ àäåíîìè ïðèùèòîïîä³áíèõ çàëîç, ÿê³ ìåaeóâàëè áåçïîñåðåäíüî ç òèðåî¿äíîþ òêàíèíîþ ïî çàäí³é ïîâåðõ-í³ ùèòîïîä³áíî¿ çàëîçè àáî áóëè ðîçòàøîâàí³ ³íòðà-òèðåî¿äíî. Ó 26 (3,8%) ïàö³ºíò³â â³çóàë³çóâàëèñü àäåíîìè ïðèùèòîïîä³áíèõ çàëîç, ëîêàë³çîâàí³ ó âåðõíüîìó, ïåðåäíüîìó òà ñåðåäíüîìó ñåðåäîñò³íí³. Íå´àòèâ-í³ ðåçóëüòàòè ñïîñòåð³ãàëèñü ó 114 ïàö³ºíò³â (16,7%). Âèñíîâîê. Ñöèíòè´ðàô³ÿ ç 99m Tc-MIBI ìຠîñîáëèâó çíà÷èì³ñòü â ä³à´íîñòèö³ ïóõëèííî¿ ïàòîëî´³¿ ïàðà-ùèòîïîä³áíèõ çàëîç, à çàñòîñóâàííÿ òåõíîëî´³¿ ÎÔÅÊÒ/ÊÒ ç 99m Tc-MIBI äຠçìîãó á³ëüø òî÷íî âñòàíîâèòè ëîêàë³çàö³þ àòèïîâî ðîçòàøîâàíèõ àäåíîì ïðèùèòîïîä³áíèõ çàëîç.

Background. Diseases of the musculoskeletal system (MSS), in particular diseases of joints, are a leading factor for reducing the work ability of the population all around the world. The early diagnosis and treatment for them is a high priority task for clinical medicine. Modern nuclear medicine methods can significantly increase the possibilities in differential diagnostics, optimize treatment and improve the prognosis of diseases of the musculoskeletal system (MOP). Purpose – to study and generalize the world experience of application of modern methods of osteoscintigraphy (OSG) for diagnostics of joints diseases, to define possibilities and prospects of various scintigraphic acquisitions for investigation patients with MSS pathology. Materials and methods. Full-text publications in the databases Scopus, Web of Science Core Collection, PubMed (mostly 2015–2021), international standard guidelines for the diagnosis of MSS pathology and monographs for radionuclide examination methods and hybrid imaging technologies in oncology, orthopedics and traumatology. Results. We received the main approaches for radiological diagnostics of pathological changes in joints and the abilities of osteoscintigraphy. We defined the main principles and analyzed the possibilities and advantages of different nuclear medicine protocols: conventional planar examination of the whole body, 3-phase OSG, single-photon emission computed tomography (SPECT) and combined technology with X-ray computed tomography (SPECT/CT). Indications for the use of OSG in various pathological changes of ORA have been determined. We considered different patterns of radiation imaging according to the pathogenesis of various pathological processes – systemic arthritis, diseases of the joints of the spine, upper and lower extremities. The possibilities of different radiological methods for diagnosing and application of different modes of OSG depending on the pathogenesis and localization of lesions were analyzed and compared. Conclusions. Performing 3-phase OSG and tomographic modes (SPECT, SPECT/CT) significantly increases the efficiency of the method for the diagnostics, determination of process activity, staging and prevalence of joint pathology, as well as for monitoring the treatment results. The method detects active metabolic processes at an early stage in the vascular, soft tissue and bone phases and determines the condition of the joints of the whole body without additional radiation exposure.