双能CT成像技术在痛风性关节炎早期诊断中的应用价值

The application of dual-energy CT imaging in early diagnosis of gouty arthritis

目的探讨双能CT成像技术在痛风性关节炎(GA)早期诊断中的应用价值。方法纳入2015年1月～2017年12月我院风湿免疫科拟诊为"GA"的早期患者64例,所有患者均接受常规实验室检查以及对受累关节行双能CT检查。GA的诊断金标准依据1977年美国风湿病学会(ACR)制定的诊断标准,分析双能CT在诊断GA中的灵敏度和特异度。结果 64例患者中58例为GA,4例为骨关节炎,2例为类风湿关节炎。双能CT诊断GA的灵敏度和特异度为93. 10%和100%。此外,对于血清尿酸正常的患者,双能CT在诊断关节尿酸盐结晶沉淀上与高尿酸水平患者相一致,差异无统计学意义(X^2=0. 074,P=0. 786)。结论双能CT作为一种非侵入的检查方法,能够准确显示关节部位尿酸盐结晶沉积,尤其在血清尿酸水平正常的患者之中,在诊断GA中具有重要的价值。

Objective To investigate the application of dual-energy CT imaging in early diagnosis of gouty arthritis.Methods 64 early-stage patients diagnosed as“Gout Arthritis”(GA)from January 2015 to December 2017 in our department of Rheumatology and Immunology were enrolled.All patients received routine laboratory examination and dual energy CT examination of the involved joints.The diagnostic gold standard for gouty arthritis was based on the diagnostic criteria formulated by the American Society of Rheumatology(ACR)in 1977,and we analyzed the sensitivity and specificity of dual energy CT in the diagnosis of gouty arthritis.Results Of the 64 patients,58 were gouty arthritis,4 were osteoarthritis,and 2 were rheumatoid arthritis.The sensitivity and specificity of dual energy CT in the diagnosis of GA were 93.10%and 100%.In addition,for patients with normal serum uric acid,dual energy CT was consistent with the diagnosis of urate crystal precipitation in patients with hyperuricemia.There was no statistically significant difference(x^2=0.074,P=0.786).Conclusion As a non-invasive method,dual energy CT can accurately display the urate crystal deposition in joints,which is of great value in the diagnosis of GA,especially in patients with normal serum uric acid level.