影像检查技术对痛风性关节炎的应用比较

Comparison of medical imaging techniques in gouty arthritis

目的比较X线、CT和磁共振成像(MRI)检查技术对痛风性关节炎的诊断应用。方法回顾性分析26例痛风性关节炎患者共62个患病关节的X线、CT和MRI影像资料,分别计算3种检查方法对病变的检出率,采用卡方检验对比分析。结果 X线、CT、MRI检查对病变关节的检出率分别为47%(29/62)、69%(43/62)、82%(51/62),两两比较差异有统计学意义(P<0.01)。病变多发于肢体远端小关节,以跖趾关节发病数为最多。CT、MRI检查对小关节病变的检出率分别为52%(32/62)、58%(36/62),均明显高于X线检查的检出率34%(21/62)。结论 X线、CT和MRI检查对痛风性关节炎均有较好的诊断能力,其中MRI检查的检出率较高、发现病变的能力较好。由于3种检查技术的偏重性不同,在临床医疗中应该联合应用。检查顺序为X线→CT→MRI较为合理。X线摄片需要注意投照体位,必要时加摄切线位;CT检查应该常规进行冠状位、矢状位的重建。

Objective To compare-the diagnosis value of X-ray, CT and MRI imaging in gouty arthritis. Methods A retrospective study was performed in 62 symptomic joint of 26 patients with gouty arthritis. For each joint, the images of X-ray, CT and MRI were collected and calculate lesion detection rate. The Chi-square test was used to analyse the diagnosis ability of X-ray, CT and MRI. Results The diagnosis positive rate of X-ray, CT and MRI were 47%（29/62）,69%（43/62） and 82%（51/62）,there were significant differences （P〈O.01）. Most of the le- sions occurred in the distal small joints of the extremities, and the incidence of metatarsophalangeal joints was the most. The detection rates of CT and MRI for small joint lesions were 52% （32/62） and 58% （36/62） respectively, the difference was not significant, but the detection rate was significantly higher than that of X-ray examination 34% （21/ 62）. Conclusion X-ray, CT and MRI were a routine imaging technique for gouty arthritis. The diagnosis performance of MRI was better than X-ray and CT. The three inspection technology had advantages, should be combined with clin- ical application in medical treatment. More reasonable order： X-ray→CT→MRI. X-ray radiography should pay atten- tion to the projection position, if necessary, take the .tangent position. CT examination should be routine coronal and sagittal reconstruction.