Доплеровский артефакт мерцания: физические механизмы и место в диагностической практике. Современное состояние вопроса

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.

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