高频超声在急性痛风性膝关节炎中的应用价值

Application of high frequency ultrasound in acute gouty knee arthritis

目的研究急性痛风性膝关节炎患者的高频超声表现,探讨高频超声在急性痛风性膝关节炎诊断中的应用价值。方法回顾性分析50例临床确诊的痛风性膝关节炎急性发作患者(GA组)共70个关节及56例非痛风性膝关节炎患者(对照组)共72个关节的高频超声声像图表现,包括:关节腔积液、滑膜增厚、滑膜血流信号、强回声光点、痛风石、股骨滑车软骨"双线征"、骨侵蚀及肌腱内高回声聚集物。结果急性痛风性膝关节炎组与非痛风性膝关节炎组在"双线"征、强回声光点、痛风石、肌腱内高回声聚集物4种超声声像差异具有统计学意义(P<0.05)。"双线"征、强回声光点、痛风石、肌腱内高回声聚集物诊断急性痛风性膝关节炎的敏感度分别为:88.6%、57.1%、57.1%、32.9%,特异度分别为:97.2%、83.3%、98.6%、93.1%,阳性预测值分别为96.9%、76.9%、93.0%、82.1%,阴性预测值分别为89.7%、66.7%、69.7%、58.8%。结论高频超声对急性痛风性膝关节炎有较高的诊断价值。

Objective To investigate the manifestations of high-frequency ultrasound in patients with acute gouty knee arthritis,and to explore the application of high-frequency ultrasound in the diagnosis of acute gouty knee arthritis.Methods A total of 50 patients diagnosed with acute gouty knee arthritis(70 joints)and 56 patients with non-gouty knee arthritis(72 joints)were enrolled.Their high-frequency ultrasonographic features were retrospectively analyzed,including:joint effusion,synovial thickening,synovial blood flow signal,strong echo light spot,gout stone, "double line sign" of the femoral trochlear cartilage,bone erosion and hyperechoic aggregates in tendon.Results There were significant differences in "double line" sign,strong echo light spot,gout stone and hyperechoic aggregates in tendon between the acute gouty knee arthritis group and the non-gouty knee arthritis group(P<0.05).For the diagnosis of acute gouty knee arthritis,the sensitivity of " double line" sign,hyperechoic light spot,gout stone and hyperechoic aggregates in tendon was 88.6%,57.1%,57.1% and 32.9%,the specificity was 97.2%,83.3%,98.6% and 93.1%,the positive predictive value was 96.9%,76.9%,93.0%and 82.1%,and the negative predictive values was 89.7%,66.7%,69.7%and 58.8%,respectively.Conclusions High frequency ultrasound has important value in the diagnosis of acute gouty knee arthritis.