双源CT对痛风性关节炎的诊断价值

Value of dual energy CT imaging in the diagnosis of gout arthritis

目的:研究双源CT(DECT)对痛风性关节炎不同发病时期的诊断价值。方法:回顾性分析弋矶山医院74例经DECT检查的痛风性关节炎患者的图像,分析DECT对不同发病时期痛风性关节炎患者痛风石检出率。结果:首次诊断为痛风性关节炎急性期发作患者15例,慢性期痛风性关节炎急性发作患者46例(合并类风湿关节炎、强直性脊柱炎患者各1例),13例患者仅有高尿酸血症。临床诊断为痛风性关节炎的男女比例为9.57∶1,平均年龄(56.2±13.5)岁。DECT对慢性期痛风性关节炎急性发作痛风石的检出率为84.78%(39/46);对首次诊断为痛风性关节炎急性期发作痛风石的检出率为60%(9/15);13例高尿酸血症未检测出痛风石。结论:DECT对痛风性关节炎在不同发病时期痛风石的检出率有差异。

Objective：To assess the value of dual-energy computed tomography（DECT） in diagnosis of gouty arthritis in different disease phase. Methods：Retrospective analysis was performed concerning the imaging property in different disease phase in 74 cases of gout arthritis undergone DECT in our department,and the detection rate for chalkstone by DECT was evaluated. Results：Fifteen patients were initially diagnosed as acute disease,and 46 as chronic gout arthritis. One patient was concomitant with rheumatoid arthritis,and another one with ankylosing spondylitis. Thirteen patients had simple hyperuricemia. Male to female ratio by clinical confirmation as gout arthritis was 9. 57∶ 1. The average age was（56. 2 ＋ 13. 5） years. The detection rate for arthritic calculus in the acute phase was 84. 78%（39/46） by DECT in the chronic cases,and 60%（9/15） in acute phase in patients initially diagnosed as gout arthritis. The joint calculus was not detected in the 13 patients with simply hyperuricemia. Conclusion：DECT may be valuable in the diagnosis of gout arthritis,particular in detection of the join calculus in different disease phase.