双源CT双能量成像技术在痛风诊断中的临床应用

目的:通过采用双源CT(dual source computed tomography,DSCT)双能量成像技术检测痛风患者关节部位尿酸盐结晶的沉积状况,探讨DSCT技术在痛风诊断中的临床应用.方法:选择我院临床确诊的痛风患者48例作为试验组,其他关节炎患者30例作为对照组(其中11例类风湿关节炎患者,16例骨关节炎患者及3例系统性红斑狼疮性关节炎),采用双源CT对两组患者行双腕关节、双膝关节、双足踝关节扫描,利用仪器配置的痛风识别软件处理原始图像,由两名临床经验丰富的影像医师对获得的数据进行分析,判断患者检查部位是否有尿酸盐结晶沉积.结果:在48例痛风患者DSCT检查中有46例发现关节内有尿酸盐沉积,痛风诊断的敏感性为46/48(95.8%);在30例对照组患者中,有2例出现伪信号影,诊断特异性为28/30(93.3%);有骨质破坏的痛风患者与无骨质破坏的痛风患者之间的尿酸盐结晶阳性检出率无明显差异(P>0.05);血尿酸水平增高和血尿酸水平正常的痛风患者,其DSCT尿酸盐结晶的检出率差异无统计学意义(P>0.05).结论:采用DSCT双能量成像技术诊断痛风具有较高的敏感性及特异性,并且可以直观无创地显示患者检测部位尿酸盐结晶的沉积情况,提示DSCT可应用于痛风病情的监测,具有较重要的临床推广应用价值.

The Application of Dual Source Computed Tomography for Gout Diagnosis

Objective:In order to analyze the clinical applications of DSCT technique in the diagnosis of gout, the adoption of "dual source CT ( dual source computed tomography, DSCT) dual energy imaging technology to detect the urate crystal deposition condition of patients with gout joints. Methods: Choosing 48 patients with clinical diagnosis of gout as the experimental group, 30 patients with other arthritis as control group ( 11 patients with rheumatoid arthritis, 16 patients with osteoarthritis and 3 cases of systemic lupus with lupus arthritis) , it used DSCT to scan double hand-wrist joints, double knee joints and double ankle joints of patients from both groups. Using the instrumental configuration of gout recognition software to process the origi-nal images, analyzed by two experienced clinical image physicians on the data obtained, it was decided wheth-er there's any urate crystal deposition within the checked parts of patients. Results:In the DSCT examination of 48 patients with gout, 46 cases were found in the joints with urate crystal deposition and the gout diagnostic sensitivity was 46/48 (95.8%). As for the 30 patients of the control group, there're 2 cases with pseudo signal and the specificity was 28/30 (93.3%). There's no obvious difference (P≥0.05) of the positive rate of urate crystals between gout patients who have bone destruction and those who do not have. It's found that the differ-ence of detection rate of DSCT urate crystals has no statistical significance (P>0.05) between gout patients who have increased blood uric acid levels and normal cases. Conclusion:It has high sensitivity and specificity when using DSCT double energy imaging in the diagnosis of gout, and the urate crystals deposition condition of patients' checked parts could be displayed intuitively with this noninvasive test. It prompts that DSCT can be applied to gout disease monitoring and has the important clinical application value.