DECT成像对痛风患者不同临床时期尿酸盐沉积量与尿酸值相关性的研究

Study on the correlation between the urate deposition quantity and uric acid value in patients with gout at different clinical period via DECT imaging

目的探讨双源CT双能量（DECT）成像技术对痛风患者不同临床时期尿酸盐结晶与血尿酸的关系，进而评估DECT成像在痛风筛查中的应用价值。方法回顾性分析120例高尿酸血症或痛风患者的DECT成像特点及临床资料，根据临床分期分为两组，男92例，女28例；对照组为非痛风患者30例，男26例，女4例。所有病例手、足均行DECT非增强扫捕，薄层再组后将原始数据传至MMWP：工作站选择Dual Energy GOUT软件，进行影像后处理，比较痛风患者两期尿酸盐沉积的差异与尿酸值相关性，以及DECT检测尿酸盐沉积部位与临床评估的差异。采用t检验、x2检验、Fisher精确概率进行统计学分析。结果：组性别及年龄比较，差异无统计学意义（P年龄=0．236，P性别=0．613，P〉0．005）。高尿酸组尿酸盐沉积量明显高于尿酸正常组，两组有显著统计学意义（P=0．00013，P〈0．001）；痛风组检出率与对照组相比。差异有显著统计学意义（P=0．00015，P〈0．001）。结论DECT成像技术对尿酸盐结晶沉积有很好的显示能力，对高尿酸血症、痛风早期、疑似痛风患者均有较高的检出率，可作为痛风筛选的常规检查项目，具有较高的临床应用价值。

Objective To evaluate the correlation between the urate crystals and blood uric acid in patients with gout at different clinical period via dual - energy CT （DECT） imaging and further to evaluate the application value of DECT in screening the gout. Methods The DECT imaging characteristics and clinical data of 120 patients with hyperuricemia or gou were retrospective- ly analyzed in this work. According to the clinical stage, the cohort was divided into two groups： the experimental group, which consisted of 92 males and 28 females and a control for the pseudogout patients, which consisted of 26 males and 4 females. All ca- ses underwent the non - enhanced DECT scanning on hands and feet. After the reconstruction for thin layers, the original data were transmitted into the MMWP workstation to carry out image post - processing by choosing Dual Energy GOUT software. Then, the difference in uric acid salt deposition and the relevance to uric acid value between the two stages of the patients with GOUT were compared and, also, the difference between the clinical evaluation and the urate deposition area detected by DECT was compared. The exact probability was statistically analyzed using t test, chi - square test, and Fisher. Results There was no statistically significant difference in gender or age among that in three groups （ Page = 0. 236, Pgender = 0. 613, P 〉 0. 005 ）. The quantity of urate deposition in high uric acid group was obviously higher than that of uric acid in the normal group, with significant sta- tistical significance （ P =0. 00013, P 〈0. 001 ）. The detection rate in Gout group was statistically significant difference compared with that in the control group, （ P = 0. 00015, P 〈 0. 001 ）. Conclusion DECT imaging has a good ability in displaying the deposition of urate crystals and has a higher detection rate for hyperuricemia, early stage of patients with gout, and suspected patients with gout. Thus, DECT imaging can be used as a routine examination for gout screening, which has high clinical value.