双能CT在痛风临床病程中的诊断价值

Diagnostic value of dual-energy CT in the clinical course of gout

目的探讨应用双能CT、X线平片、核磁共振(MRI)在痛风不同临床病程分期中的诊断价值。方法选择2020年1月至2021年8月在合浦县人民医院门诊或住院的80例高尿酸血症和痛风患者,根据痛风临床病程分期标准分为无症状高尿酸血症期组7例,急性发作期组37例,发作间歇期组12例,慢性痛风石病变期组24例。痛风部位足踝关节56例,膝关节21例,手关节10例,两个部位17例,多部位8例。采用双能CT、X线平片和MRI检查,分析三种影像学检查在痛风临床病程分期中的阳性结果。结果双能CT、X线平片和MRI总阳性率分别为93.8%、37.5%、58.8%。双能CT在无症状高尿酸血症期阳性率达57.1%,而X线平片和MRI未有阳性征象发现。结论双能CT检查有助于发现痛风患者关节及周围软组织中的尿酸盐晶体,较X线影像和MRI影像更早出现阳性结果,作为痛风特异性诊断方法在临床有较高的应用价值。

Objective To explore the diagnostic value of dual-energy computed tomography(CT),X-ray plain film and magnetic resonance imaging(MRI)in different clinical stages of gout.Methods A total of 80 patients with hyperuricemia and gout who were the outpatients or inpatients in Hepu People′s Hospital from January 2020 to August 2021 were selected and divided into asymptomatic hyperuricemia group(7 cases),acute episode group(37 cases),intermittent episode group(12 cases),and chronic tophi lesion group(24 cases)according to the staging criteria of the clinical course of gout.The patients including fifty-six cases with gout at ankle joints,21 cases at knee joints,10 cases at hand joints,17 cases at two sites and 8 cases at multiple sites were examined by dual-energy CT,X-ray plain film and MRI.The positive results of the three imaging examinations in the stages of the clinical course of gout were analyzed.Results The total positive rates of dual-energy CT,X-ray plain film and MRI were 93.8%,37.5%and 58.8%,respectively.The positive rate of dual-energy CT in asymptomatic hyperuricemia stage was 57.1%,but no positive signs were found in X-ray plain film and MRI.Conclusion Dual-energy CT is helpful to find urate crystals in joints and the surrounding soft tissues of patients with gout,and the positive results showed by dual-energy CT are earlier than those showed by X-ray and MRI imaging.Dual-energy CT has higher clinical application value as a specific diagnosis method of gout.