肌骨超声与CT双能量成像在痛风性关节炎诊断中的应用比较

Comparison of Musculoskeletal Ultrasonography and Dual-energy CT Imaging in the Diagnosis of Gouty Arthritis

目的 对比肌骨超声与CT双能量成像在痛风性关节炎诊断中的应用效果。方法 对2021年1~12月在本院进行治疗的104例痛风性关节炎患者进行回顾性分析,根据诊断方式不同分为A组(n=54)及B组(n=50)。A组采取肌骨超声诊断,B组采取CT双能量成像诊断,对比两组患者诊断准确率、灵敏度及特异度,对比两组患者关节病变(骨侵蚀、关节积液、滑膜增生)检出率。结果 A组共检查69个肿痛关节,B组共检查65个肿痛关节,其中A组金标准确诊病变关节数为65个,B组为59个。A组诊断准确率、灵敏度及特异度分别为95.65%、96.92%及75.00%,B组诊断准确率、灵敏度及特异度分别为93.85%、96.61%及66.67%,两组比较差异无统计学意义(P>0.05)。A组骨侵蚀、关节积液及滑膜增生检出率分别为43.48%、42.03%及63.32%,B组骨侵蚀、关节积液及滑膜增生检出率分别为41.54%、40.00%及29.23%,A、B两组在骨侵蚀、关节积液检出率比较差异无统计学意义(P>0.05),但A组滑膜增生检出率明显要高于B组,差异有统计学意义(P<0.05)。结论 肌骨超声与CT双能量成像均能够对痛风性关节炎做出有效诊断,具有较高的准确率及灵敏度。然而肌骨超声在滑膜增生检出率上明显要优于CT双能成像,体现出了一定优势。

Objective To compare the application effect of musculoskeletal ultrasound and dual-energy CT imaging in the diagnosis of gouty arthritis.Methods A retrospective analysis of 104 patients with gouty arthritis who were treated in our hospital from January 2021 to December 2021 was divided into group A(n=54)and group B(n=50)according to different diagnostic methods.Group A was diagnosed by musculoskeletal ultrasound,and group B was diagnosed by dualenergy CT imaging.The diagnostic accuracy,sensitivity and specificity of the two groups were compared.The detection rates of joint lesions(bone erosion,joint effusion,synovial hyperplasia)were compared between the two groups.Results 69 swollen and painful joints were examined in group A,and 65 swollen and painful joints were examined in group B.Among them,65 joints were diagnosed by the gold standard in group A and 59 in group B.The diagnostic accuracy,sensitivity and specificity of group A were 95.65%,96.92%and 75.00%,and the diagnostic accuracy,sensitivity and specificity of group B were 93.85%,there was no significant difference between the two groups(P>0.05).The detection rates of bone erosion,joint effusion and synovial hyperplasia in group A were 43.48%,42.03%and 63.32%,and the detection rates of bone erosion,joint effusion and synovial hyperplasia in group B were 41.54%,40.00%and 29.23%.There was no significant difference in the detection rate of bone erosion and joint effusion between groups A and B(P>0.05),but the detection rate of synovial hyperplasia in group A was significantly higher than that in group B,the difference was statistically significant(P<0.05).Conclusion Both musculoskeletal ultrasound and dual-energy CT imaging can effectively diagnose gouty arthritis with high accuracy and sensitivity.However,musculoskeletal ultrasound is obviously superior to dual-energy CT imaging in the detection rate of synovial hyperplasia,which shows certain advantages.