肌肉骨骼超声与MRI在老年痛风性关节炎患者诊治中的应用

目的比较肌肉骨骼超声(MSUS)与MRI在老年痛风性关节炎(GA)患者诊治中的诊断效能,探讨MSUS在老年GA诊断中的应用价值。方法回顾性分析2017年6月-2018年6月于本院接受诊治的104例可疑GA老年患者临床资料,患者均有完整MSUS、MRI影像资料,分别根据患者MSUS、MRI影像报告,结合临床症状对患者进行初步诊断,并与最终标准诊断结果进行对比,比较两组检查方式对老年GA诊断效能及一致性。结果结果显示,MSUS诊断灵敏度76.19%、特异度75.61%、准确度75.96%、阳性预测值82.76%、阴性预测值67.39%,MRI诊断灵敏度90.48%、特异度80.49%、准确度86.54%、阳性预测值87.69%、阴性预测值84.62%;MSUS灵敏度、阴性预测值显著低于MRI诊断;两种诊断具有较好的一致性(Kappa=0.549)。结论MSUS诊断老年GA患者在灵敏度上不如MRI,但整体上两种检查有较好的一致性,且MSUS较MRI有价格便宜、可重复性高等优势,值得用于老年GA患者诊治中。

Application of Musculoskeletal Ultrasound and MRI in the Diagnosis and Treatment of Elderly Patients with Gouty Arthritis

Objective To compare the diagnostic efficacy of musculoskeletal ultrasound(MSUS)and MRI in the diagnosis and treatment of elderly patients with gouty arthritis(GA),and explore the application value of MSUS in the diagnosis of elderly GA.Methods The clinical data of 104 patients suspected as GA who were treated in our hospital from June 2017 to June 2018 were retrospectively analyzed.All patients had complete MSUS and MRI images,and the initial diagnosis was performed on patients according to MSUS and MRI images combined with clinical symptoms,and the final standard diagnostic results were compared,and the diagnostic efficacy and consistency of the two examination methods for elderly GA was compared.Results The results showed that the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 76.19%,75.61%,75.96%,82.76%and 67.39%by MSUS,and were 90.48%,80.49%,86.54%,87.69%and 84.62%by MRI.The sensitivity and negative predictive value of MSUS were significantly lower than those of MRI.The two diagnoses had good consistency(Kappa=0.549).Conclusion MSUS has poorer sensitivity than MRI in the diagnosis of elderly patients with GA,but the two examinations both have good consistency in general,and MSUS has the advantages of cheaper price and higher repeatability than MRI,and it is worthy of being used in the diagnosis and treatment of elderly patients with GA.