双能量CT对痛风性关节炎的诊断价值

Diagnostic value of dual-energy CT in gouty arthritis

目的:探讨双能量CT扫描对痛风性关节炎的诊断价值。方法:选取疑似痛风性关节炎患者91例,均给予双能量CT扫描。结果:金标准确诊痛风性关节炎71例,非痛风性关节炎20例;双能量CT诊断痛风性关节炎68例,非痛风性关节炎23例。双能量CT诊断痛风性关节炎的灵敏度、特异度、阳性预测值和阴性预测值分别为91.55%、85.00%、95.59%和73.91%;双能量CT对间歇慢性期痛风结节、骨质破坏的检出率分别为95.12%和65.85%,明显高于急性期(P<0.05);双能量CT对尿酸值<420μmol/L和≥420μmol/L患者痛风结节和骨质破坏检出率比较无统计学差异(P>0.05)。结论:双能量CT扫描对痛风性关节炎有较好的诊断价值。

Objective To investigate the diagnostic value of dual-energy CT in gouty arthritis. Methods A total of 91 patients with suspected gouty arthritis were scanned by dual-energy CT. Results According to the golden standard, 71 patients were diagnosed with gouty arthritis, while the others were diagnosed with non-gouty arthritis. The results of dual-energy CT showed that there were 68 cases of gouty arthritis and 23 cases of non-gouty arthritis. The sensitivity, specificity, positive predictive value and negative predictive value of dual energy CT in the diagnosis of gouty arthritis were 91.55%, 85.00%, 95.59% and 73.91%, respectively. The detection rates of dual-energy CT in gout nodules and bone destruction in intermittent chronic phase were 95.12% and 65.85%, respectively, which were significantly higher than those in acute phase (P<0.05). No significant difference was found in the detection rate of dual-energy CT in gouty nodules and bone destruction between patients with uric acid <420 μmol/L and those with uric acid ≥420 μmol/L (P>0.05). Conclusion Dual-energy CT scan has great diagnostic value in gouty arthritis and is worthy of clinical application.