双能CT检查对痛风性关节炎的临床价值研究

Study on the Clinical Value of Dual Energy CT in Gouty Arthritis

目的探讨双能CT检查诊断痛风性关节炎的临床应用价值。方法方便选取2016年1月—2018年12月该院收治的痛风性关节炎68例作为痛风组以及选取同期收治的50例非痛风性患者作为非痛风组,两组患者均行DECT检查。比较两组患者一般资料以及分析双能CT诊断痛风性关节炎的准确性。结果痛风组病程[(4.12±2.32)年vs(2.51±1.86)年,t=8.315]及血尿酸含量[(474.28±80.78)μmol/Lvs(306.41±60.53)μmol/L,t=14.843]高于非痛风组(P<0.05);DECT检查诊断痛风性关节炎的灵敏度为88.2%(60/68),特异度92.0%(46/50),阳性预测值为93.8%(60/64),阴性预测值为85.2%(46/54);68例患者经DECT检查出尿酸盐结晶沉积部位一共413处,医生临床评估确诊尿酸盐结晶沉积部位137处,DECT检出数量为临床诊断的3.01倍。结论双能CT检查尿酸盐结晶沉积准确率高,对临床诊断痛风性关节炎具有较好的应用价值。

Objective To explore the clinical application value of dual energy CT in the diagnosis of gouty arthritis.Methods 68 cases of gouty arthritis treated in our hospital from January 2016 to December 2018 were convenient selected as the gout group and 50 non-gout patients admitted during the same period were selected as the non-gout group.Both groups of patients underwent DECT.The general data of two groups of patients were compared and the accuracy of dual energy CT in the diagnosis of gouty arthritis was compared.Results The duration of disease in the gout group[(4.12±2.32)years vs(2.51±1.86)years,t=8.315]and blood uric acid content[(474.28±80.78)μmol/L vs(306.41±60.53)μmol/L,t=14.843]were higher than those in the non-gout group(P<0.05);The sensitivity of DECT in the diagnosis of gouty arthritis was 88.2%(60/68),the specificity was 92.0%(46/50),the positive predictive value was 93.8%(60/64),and the negative predictive value was 85.2%(46/54);A total of 413 urate crystal deposition sites were detected by DECT in 68 patients,and 137 urate crystal deposition sites were confirmed by the doctor's clinical evaluation.The number of DECT detection was 3.01 times that of clinical diagnosis.Conclusion Dual-energy CT has a high accuracy rate for urate crystal deposition,and it has good application value for clinical diagnosis of gouty arthritis.