双源CT对临床疑似痛风性关节炎的诊断价值

Dual Source CT in Diagnosis of Clinically Suspected Gouty Arthritis

目的:通过双源CT对痛风性关节炎检出率的组间对比来评价双能CT(DECT,Dual Energy Computed Tomography)在临床疑似痛风性关节炎患者中的诊断价值。材料与方法:收集在泰州人民医院就诊并行DECT痛风检査的120例病人。根据临床诊断标准及实验室检查分为3组,A组(参照1977年美国风湿病学会(ACR)制订的痛风诊断标准)临床确诊的痛风性关节炎40例;B组(参照ACR标准)临床疑似痛风性关节炎40例;C组(对照组):40例。分析三组DECT对尿酸盐结晶的检出情况,并以临床诊断为标准,计算其对临床疑似痛风性关节炎的敏感性、特异性、假阴性率、假阳性率、阴性预测值、阳性预测值。结果:三组对尿酸盐结晶的检出率比较差异有统计学意义,A组最高(95.0%);同时,DECT检测临床疑似痛风性关节炎的敏感性为92.86%,特异性为75.0%,假阴性率为7.14%,假阳性率为25.0%。结论:DSCT双能量技术对痛风性关节炎尿酸盐结晶的检出率较高,同时在临床疑似痛风性关节炎患者的诊断中有较高的敏感性及特异性,假阴性及假阳性率较低,可以作为临床疑似痛风性关节炎的无创性检查手段。

Purpose： To evaluate the diagnostic value of dual energy Computed Tomography in diagnosing clinically negative gouty arthritis by comparing the detection rate in different groups through dual source CT scans. Materials and Methods： 45 patients of gout visited in Tai Zhou People＇s Hospital and checked by DECT were collected. According to clinical diagnostic criteria and laboratory tests,these 45 patients was divided into 3 groups： 40 patients with gout arthritis（ ACR）was Group A,40 patients with clinically negative gout arthritis was Group B,40 cases was Group C（ control group）. The detection of uric acid salt crystallization in the three groups of DECT was analyzed,and the sensitivity,specificity,false negative rate,false positive rate,false positive rate,negative predictive value,positive predictive value were calculated. Results： The three groups had statistically significant difference in the detection rate of uric acid salt crystallization,A group（ 95. 0%） was the highest,according to clinical diagnosis / screening test,Sensitivity of clinical negative gout arthritis by DECT detection was 92. 86%,specificity was 75. 0%,false negative rate 7. 14%,false positive was 25. 0%. Conclusion： Dual energy technology of DSCT has a higher detective rate in the crystallization of gout arthritis. At the same time,it also has a high sensitivity and specificity in diagnosing of clinical negative gout arthritis,meanwhile false negative and false positive rate is low,it can be used as a non-invasive detection method for clinical negative gout arthritis.