Современные подходы к оценке костных нарушений при первичном гиперпаратиреозе: потенциал 3D-моделирования бедренной кости

Первичный гиперпаратиреоз (ПГПТ) является распространенным эндокринным заболеванием, сопровождающимся избыточной секрецией паратиреоидного гормона и нарушением минерального обмена, что приводит к снижению минеральной плотности костной ткани (МПК) и увеличению риска переломов. Для оценки состояния костной системы традиционно используются рентгенография, двухэнергетическая рентгеновская абсорбциометрия (DXA), количественная компьютерная томография (ККТ), периферическая ККТ высокого разрешения и радиочастотная эхографическая мультиспектрометрия (REMS). Однако эти методы имеют определенные ограничения, что обусловливает необходимость поиска новых диагностических подходов. В последние годы активно развивается 3D-моделирование бедренной кости (3D-DXA), позволяющее проводить трехмерный анализ плотности и структуры костной ткани на основе данных DXA. Этот метод демонстрирует высокую точность и корреляцию с ККТ, обеспечивая более детальную оценку изменений в кортикальном и трабекулярном компонентах. Применение 3D-DXA открывает новые перспективы в диагностике и мониторинге костных осложнений при ПГПТ, что может способствовать более точному прогнозированию риска переломов и персонализированному выбору терапевтической тактики.

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