痛风性关节炎患者超声特征及与CT、MRI的对比分析

Ultrasound Features of Patients with Gouty Arthritis and Comparison with CT and MRI

目的分析痛风性关节炎患者超声特征,并与CT、MR比较,以明确其应用价值。方法回顾性分析2017年1月至2018年12月在本院就诊的61例痛风性关节炎患者的超声、CT、MRI影像资料,分析痛风性关节炎患者超声特征,并与常规CT、MR比较。结果三种影像学手段在骨质破坏上的关节检出率比较差异无统计学意义(P>0.05);常规CT、MRI对软组织和骨内痛风石征象、软组织肿胀、关节积液的检出率显著高于超声(P<0.05),且MRI对软组织肿胀、关节积液关节的检出率显著高于常规CT(P<0.05),但超声、CT均未检出骨髓水肿征象;且超声检出97例尿酸盐结晶沉积,常规CT、MRI未见。结论超声可在一定程度上反映痛风性关节炎痛风石、骨质破坏等情况,尤其在尿酸盐结晶沉积显示上优势显著,但在滑膜增厚、骨髓水肿征象的显示上存在不足,或可通过加行MRI作补充。

Objective To analyze the ultrasound features of patients with gouty arthritis and compare them with CT and MR,to clarify its application value.Methods The imaging data of ultrasound,CT and MRI of 61 patients with gouty arthritis who were treated in our hospital from January 2017 to December 2018 were analyzedretrospectively.The ultrasound features of patients with gouty arthritis were analyzed and compared with CT and MR.Results There was no significant difference in the detection rate of joints on bone destruction among the three imaging methods(P>0.05).The detection rates of soft tissue and intraosseous tophi signs,soft tissue swelling and joint effusion by CT and MRI were significantly higher than those by ultrasound(P<0.05),and the detection rates of soft tissue swelling and joint effusion by MRI were significantly higher than those by CT(P<0.05),but no periosteal thickening and bone marrow edema were detected by ultrasound and CT.97 cases of urate crystal deposition were detected by ultrasound,but could not be seen by CT and MRI.Conclusion Ultrasound can reflect the situation of gouty arthritis,gout stone and bone destruction to a certain extent,especially in the display of urate crystal deposition,but there are deficiencies in the display of synovial thickening and bone marrow edema,or can be supplemented by MRI.