双能CT彩色编码图对尿酸盐沉积的诊断价值

The Application Value of DECT Color-coded Map for Detecting Uric Acid Deposition

目的评价双能CT(DECT)彩色编码图检测尿酸盐沉积的临床价值。方法24例痛风患者纳入本研究,其中有痛风史者13例(根据美国风湿病协会标准),临床怀疑痛风者6例,另5例检查前未考虑到痛风可能性。根据不同检查部位,分别进行DECT扫描,同时获得140、80kvp和混合能量图(相当于常规单能量120KV图像),利用DECT Gout软件后处理得到伪彩色编码图,分别由2名医师对平均加权120kvp图和伪彩色编码图独立进行评价,主要观察尿酸盐沉积的部位、数目、大小等。结果24例均显示不同部位、数目、大小的尿酸盐沉积,DECT彩色编码图较混合能量图(相当于常规单能量120KV图像)显示了更多数目的痛风石,具有更强的显示尿酸盐结晶的能力(P<0.05)。对于13例临床确诊痛风患者,DECT能更好显示微小、亚临床部位的痛风石;对于6例临床可疑痛风患者及5例之前未考虑到痛风可能性的患者,明确或提示了痛风的诊断。两位医师利用DECT彩色编码图评估痛风石数目的差异无显著性(P>0.05),而利用混合能量图(相当于常规单能量120KV图像)差异有显著性(P<0.05)。结论 DECT彩色编码图具有更强的显示痛风石能力,且更为形象直观,可作为痛风筛查手段,有助于全面评估病情,具有较大的临床应用价值。

Objective To assess the clinical value of dual energy computed tomography（DECT） color-coded map for detect uric acid deposition. Methods 24 cases of gout patients enrolled in the study, 13 cases with a history of gout（according to the American College Rheumatology Criteria）, clinical suspicion of gout were 6 cases, the other 5 cases did not take into account the possibility of gout before the examination. DECT dual-energy scanning was conducted to obtain 140,80 kvp and hybrid energy diagram（equivalent to conventional energy120 KV single image） simultaneously at different checkpoints. Pseudo-color coded map was derived after processing by DECT Gout software. Two physicians independently evaluate the average weighted 120 kvp diagrams and pseudo-color coded map respectively, mainly observing the location, number and size of urate deposition. Resultsesults All of the 24 cases have showed the different location, number, size of urate deposition, DECT color-coded map has represented a greater number of urate deposition than mixing energy tomography（equivalent to conventional energy 120 KV single image） and have a stronger capability to display more urate deposition（P〈0.05）. For 13 cases of gout confirmed by clinical,DECT was more excellent for demonstrating the urate deposition in tiny subclinical parts for the 13 cases of gout confirmed by clinical and could make a definitive or suggest diagnosis for the 6 cases of clinically suspicious and five cases of gout patients not previously taken into account the possibility of gout.Two physicians to assess urate deposition numbers which used of DECT has no significant difference（P〈0.05）, and the use of hybrid energy imaging（equivalent to conventional energy 120 KV single image） has significant difference（P〈0.05）. Conclusion DECT has stronger ability in displaying urate deposition, further more,it can be used as screening of gout. DECT is of clinical worthy in a comprehensive assessment of the clinical condition and clinical application.