双能量CT处理技术对痛风性关节炎尿酸盐结晶沉积的诊断价值

Diagnostic value of dual-energy CT techniques in urate crystals deposition of gouty arthritis

摘要:

目的探讨双能量CT（DECT）处理技术对痛风性关节炎尿酸盐结晶沉积的诊断价值。方法收集常州市第二人民医院收治的190 例痛风性关节炎患者的临床资料，所有患者入院后均接受DECT 检查，且临床及影像学资料完整，分析DECT对痛风性关节炎尿酸盐结晶沉积的诊断价值。结果观察组DECT扫描见尿酸盐结晶沉积171例，诊断敏感性为90.00%；171 例DECT均可见尿酸盐沉积，见弥漫性绿色影，共发现542处，主要分布于四肢关节及附近结缔组织内，双足及踝关节、膝关节、双手及腕关节及肘关节病灶数分别为321、206、12及3处；尿酸盐结晶沉积最长径线<5 mm尿酸盐结晶共417 处（76.94%），5～10 mm共108 处（19.93%），>10 mm共17 处（3.14%）；结晶形态多数不规则，部分呈点状。结论双能量CT 对痛风性关节炎尿酸盐结晶沉积检测率高，与病理穿刺一致性高，且对非典型部位尿酸盐结晶沉积显示率高，可为痛风性关节炎患者临床诊疗提供依据。

Abstract:

Objective To explore the diagnostic value of dual -energy CT (DECT) in urate crystals deposition (MSU) of gouty arthritis. Methods The clinical data of 190 patients with gouty arthritis in our hospital were collected. All the patients received DECT after admission, and their clinical and imaging data were complete. The diagnostic value of DECT in MSU of gouty arthritis was analyzed. Results The DECT scan showed that there was MSU in 171 cases, with the diagnostic sensitivity of 90.00%. There was diffuse green shadow in 542 sites, mainly distributed in the joints and nearby connective tissues. The number of lesions in double feet and ankle joints, knee joints, hands and wrist joints and elbow joints was 321, 206, 12 and 3, respectively. There were 417 sites (76.94%) where the longest diameter of MSU was less than 5 mm, 108 sites (19.93%) with the longest diameter of 5-10 mm, and 17 sites (3.14%) with that of more than 10 mm.Most MSU were irregular in shap, and some of them were spot-like. Conclusions The detection rate of DECT in MSU of gouty arthritis is high, whose result was consistent with that of pathological biopsy; and the display rate in atypical location of MSU is also high, which can provide basis in clinical diagnosis and treatment of patients with gouty arthritis.