能谱CT检测下肢关节周围尿酸盐结晶沉积的应用研究

Application of energy spectrum CT in detecting urate crystal deposition around lower limb joints

目的:探讨应用能谱CT成像技术检测下肢关节周围尿酸盐(MSU)结晶沉积的临床价值。方法:选取90例拟诊断为痛风性关节炎(GA)的患者作为研究对象,均接受下肢关节能谱CT成像技术及常规实验室检查,以后者检查结果为准,分析能谱CT成像技术对GA的诊断价值。结果:应用能谱CT成像技术检查,有77例见MSU结晶沉积,其与常规实验室检查的一致性较强(Kappa=0.732)。77例GA患者中检查出膝关节44例(218处MSU结晶沉积区),足踝关节48例(162处MSU结晶沉积区)。77例GA患者重度MSU沉积组(n=11)、中度MSU沉积组(n=36)、轻度MSU沉积组(n=30)间的MSU结晶数积分和临床症状积分均有统计学差异(P<0.05),均表现为重度MSU沉积组>中度MSU沉积组>轻度MSU沉积组(P<0.05)。Pearson分析显示,GA患者MSU结晶计数与临床症状正相关(r=0.739,P<0.05)。结论:能谱CT成像技术对下肢关节周围MSU结晶沉积有较高显示率,在GA早期诊断中具有重要价值。

Objective:To explore the clinical value of applying energy spectrum CT imaging technology on detecting monosodium urate(MSU)crystal deposition around lower limb joints.Methods:90 patients who were diagnosed with possible gouty arthritis(GA)received energy spectrum CT imaging technology of lower limb joints and conventional laboratory examination.The diagnostic value of energy spectrum CT imaging technology on conventional laboratory examination was analyzed based on the results of the latter examination.Results:There were 77 cases of MSU crystal deposition by energy spectrum CT imaging,and the consistency with conventional laboratory examination was strong(Kappa=0.732).Among the 77 patients with GA,44 cases of knee joints(218 MSU crystal deposition areas)and 48 cases of ankle joints(162 MSU crystal deposition areas)were detected.There were significant differences in score of MSU crystal count and score of clinical symptom among 77 GA patients of severe MSU deposition group(n=11),moderate MSU deposition group(n=36)and mild MSU deposition group(n=30)(P<0.05),which were manifested as severe MSU deposition group>moderate MSU deposition group>mild MSU deposition group(P<0.05).Pearson analysis showed that the MSU crystal count in patients with GA was positively correlated with clinical symptom(r=0.739,P<0.05).Conclusion:Energy spectrum CT imaging technology has a high display rate of MSU crystal deposition around the lower limb joints,and it is of great value in the early diagnosis of GA.