痛风性关节炎的X线、CT和MRI诊断价值研究

The Diagnostic Value of X-ray, CT and MRI in Gouty Arthritis

目的探析X线、CT、MRI在痛风性关节炎患者中的诊断价值。方法在该院2017年10月-2019年3月收治的痛风性关节炎患者中便利选出120例为对象,均进行X线、CT、MRI检查,收集整理3种方法的诊断准确率等。结果 X线、CT、MRI对痛风性关节炎的诊断准确率(69.17%vs 85.00%vs 95.00%)对比差异有统计学意义(χ~2=28.936,P<0.05);X线的诊断准确率低于CT,CT诊断准确率低于MRI (P<0.05);病变关节检出率对比:X线、CT、MRI分别为62.72%、77.19%、93.42%,3种方法之间差异有统计学意义(χ~2=62.239,P<0.05);相关征象检出率对比3种方法之间差异有统计学意义(P<0.05),两两比较其中骨内痛风石检出率和关节面下囊变的检出率CT与MRI之间差异无统计学意义(P>0.05);软组织肿胀、关节软骨侵蚀、关节积液和滑膜韧带损伤的检出率比较,CT明显低于MRI(P<0.05)。结论X线、CT、MRI在痛风性关节炎的诊断中均有一定价值,MRI的诊断准确率高,发现病变关节、病变征象的准确率高,CT在骨质破坏方面检出上有优势,X线则适用于中晚期病变复查中;3种影像学手段各有侧重,应合理应用。

Objective To explore the diagnostic value of X-ray and CT,MRI in patients with gouty arthritis. Methods From October 2017 to March 2019, 120 patients with gouty arthritis were convenienty selected and examined by X-ray and CT,MRI, and the diagnostic accuracy of the three methods was collected and sorted out. Results The diagnostic accuracy of Xray, CT and MRI for gouty arthritis(69.17% vs 85.00% vs 95.00%) was significantly different(χ~2=28.936, P <0.05).The diagnostic accuracy of X-ray was lower than that of CT, and that of CT was lower than that of MRI(P<0.05). Comparison of detection rate of diseased joints: X-ray, CT and MRI were 62.72%, 77.19% and 93.42%, respectively. The differences between the three methods were statistically significant(χ~2=62.239, P <0.05).And there was significant difference in the detection rate of related signs between the three methods(P<0.05). There was no statistically significant difference between CT and MRI in the detection rate of intraosseous gouty stone and subarticular bursa(P>0.05). The detection rate of soft tissue swelling, articular cartilage erosion, joint fluid accumulation and synovial ligament injury was significantly lower than that of MRI(P<0.05). Conclusion X-ray and CT,MRI have certain value in the diagnosis of gouty arthritis. The diagnostic accuracy of MRI is high, and the accuracy of finding diseased joints is high. CT has advantages in the detection of bone destruction, X-ray is suitable for the reexamination of middle and late lesions, and each of the three imaging methods has its own emphasis and should be used reasonably.