双能量CT对急性痛风结晶的评估及相关因素分析

目的:采用单源双能量CT(dual energy CT,DECT)处理技术测定痛风性关节炎患者急性发作时的尿酸盐结晶沉积量多少,评估其临床诊断价值,探讨尿酸盐结晶及相关影响因素.方法:选取2018年1月—2020年12月在高新区人民医院因急性痛风性关节炎住院的116例拟诊患者的病例资料并进行分析.所有患者均接受关节DE...

Evaluation of urate crystallization in acute gouty arthritis by dual energy CT and analysis of related factors

Objective To determine the amount of urate crystal deposition in patients with gouty arthritis during acute attack by dual energy CT(DECT),evaluate its clinical diagnostic value,and explore urate crystal and related influencing factors.Methods The case data of 116 patients hospitalized for acute gouty arthritis in High tech Zone People's hospital from January 2018 to December 2020 were selected and analyzed.All patients underwent joint DECT scanning.The patients with gout were divided into groups according to the level of uric acid.The relationship between gout crystallization and age,gender,body mass index(BMI),course of disease and uric acid level was analyzed.Results Among the 116 patients,106 were diagnosed as gout according to the latest classification standard of EULAR/ACR gout in 2015.The specificity,sensitivity and accuracy of DECT were 80.0%,88.7%and 87.9%.The positive and negative results of DECT in 106 patients with gouty arthritis were positively correlated with BMI and course of disease.According to the uric acid level 420μmol/L as the boundary point,they were divided into normal uric acid group and high uric acid group.Those greater than 420μmol/L were subdivided into three groups.It was found that there was a statistically significant difference in the detection rate of DECT crystallization between patients with uric acid value greater than 420μmol/L and those less than 420μmol/L.Conclusion Single source dual energy CT has good sensitivity and specificity in the diagnosis of gout.The detection of gout crystal deposition by dual energy CT is positively correlated with the level of blood uric acid,which can provide clinical diagnosis and treatment basis for the evaluation and classification of the severity of gouty arthritis.Dual energy CT has good diagnostic value for acute and chronic gouty arthritis by evaluating the deposition of urate crystal,At the same time,it is suggested that the course of disease and BMI are positively correlated with the detection rate of gout crystallization.The level of blood uric acid is an independent influencing factor of urate crystallization,which plays an important clinical guiding role in the further treatment of gout.