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目的探讨双源CT双能量成像(DECT)技术在四肢关节早期痛风尿酸盐结晶检测中的作用和价值。方法回顾性研究搜集到的按照美国风湿病学会(ACR)1977年分类标准确诊为早期痛风的85例患者的临床资料,设为病例组,对照组为25例因临床需要行四肢关节检查的非痛风患者,比较两组在尿酸盐结晶检出率、沉积部位、大小及形态等方面的差异。结果在85例早期痛风组中,74例(急性痛风性关节炎期69例,痛风无症状期5例)检测出绿色尿酸盐结晶,总共563处,第一跖趾关节周围是最易沉积的部位,对照组均未检出尿酸盐结晶;两组在尿酸盐结晶检出率方面的差异具有统计学意义。DECT对早期痛风组检测的敏感性为87.06%(74/85),特异性为100%,假阳性率为0,假阴性率为12.94%(11/85)。结论 DECT能够检测出位置深、体积小、数量少的尿酸盐晶体,并能测量晶体大小,检测病情变化,对早期痛风尿酸盐结晶的检出率很高,在早期痛风的诊治及鉴别等方面具有很大的应用价值和潜能。
Objective To investigate the value and significance of dual-source CT dual-energy imaging (DECT) in the detection of urate crystals in the early stage of joint pain of limbs. Methods The clinical data of 85 patients diagnosed with early gout according to the American College of Rheumatology (ACR) classification criteria in 1977 were retrospectively studied. The data were included in the case group and 25 in the control group as limb-joint examination due to clinical needs Gout patients, the two groups in the urate crystallization detection rate, deposition site, size and shape differences. Results In 85 early gout groups, green urate crystals were detected in 74 of 74 patients (69 with acute gouty arthritis and 5 with gouty asymptomatic conditions), for a total of 563, the most likely to deposit around the first metatarsophalangeal joint Of the control group were not detected urate crystals; two groups in the urate crystal detection rate differences were statistically significant. The sensitivity of DECT to early gout test was 87.06% (74/85), the specificity was 100%, the false positive rate was 0 and the false negative rate was 12.94% (11/85). Conclusions DECT can detect urate crystals with deep position, small volume and small number, and can measure the crystal size and detect the change of the disease. The detection rate of urate crystals in early gout is very high. Diagnosis and treatment of early gout Etc. have great application value and potential.