双能量CT双技术在痛风的应用价值

发布时间：2018-04-26 23:13

本文选题：痛风 + 尿酸盐结晶　；参考：《临床放射学杂志》2016年03期

【摘要】：目的评价双能量CT(DSCT)尿酸盐结晶检测技术(gout)和综合技术(general)在痛风检测中的应用价值。方法 (1)回顾性分析61例(64对部位)关节肿痛患者行DSCT扫描并分别经gout及general两种技术成像,所得图像分别设为A、B组,统计两组方法所显示尿酸盐结晶(MSU)数量,每一个小关节或一处肌腱、韧带为一个计量,并用t检验比较两组图像中痛风诊断的敏感性和特异性。(2)选取长径5 mm MSU 30个,在两组图像上分别测量同一MSU最大截面积,用t检验比较两组面积差异。(3)比较A、B两组微小骨质破坏的检出。(4)比较两组在小灶MSU数量(长径3mm)的检出。结果 (1)共检测61例(64对部位),符合2012年美国风湿病学会痛风关节炎诊断60例,非痛风关节炎4例。其中A组MSU 59例,396处,敏感性92.18%(59/64),特异性80%(4/5)。B组MSU 49例,206处。显示MSU敏感性80.3%(49/64),特异性60%(3/5)。A、B组均有高敏感性和特异性。A组敏感性和特异性较B组稍高,但t检验P0.05。(2)A组测MSU最大截面积(129.26±5.16)mm~2;B组最大截面积(308.47±32.6)mm~2;t检验显示两组面积差异有显著性(P=0.036)。(3)在微小骨质破坏(3 mm)显示方面,B组明显优于A组;(4)在小灶(3 mm)MSU识别方面,A组图像能快速识别和定位病灶;B组图像容易漏诊漏判。结论 DSCT gout和general技术对痛风检测均具有很高敏感性和较高特异性;gout技术优势在对尿酸盐小病灶的快速识别和定位;general技术优势在显示微小骨质破坏。两者联合应用有利于痛风患者MSU负荷评价和骨关节侵蚀评价。
[Abstract]:Objective to evaluate the application value of dual energy CTT (DSCT) uric acid crystal detection technique (gout) and synthetic technique (general) in the detection of gout. Methods A retrospective analysis of 61 patients with pain and swelling of the joint was performed by DSCT and gout and general respectively. The images were divided into two groups: group A (group B) and group B (group A). The number of crystals of uric acid crystals in the two groups was counted. Each facet joint or tendon and ligament were measured. The sensitivity and specificity of gout diagnosis in the two groups were compared by t test. 30 cases with 5 mm long diameter MSU were selected. The maximum cross-sectional area of the same MSU was measured on the two groups of images. T test was used to compare the area difference between the two groups. The detection rate of microbone destruction in group A and B was compared with that in group A and B) and the number of small focus MSU (3 mm in length) was compared between the two groups. Results 61 cases (64 pairs) were detected, 60 cases were diagnosed by American Society of Rheumatology in 2012, and 4 cases were non-gout arthritis. In group A, there were 59 cases of MSU with 396 sites, sensitivity of 92.18% to 59% 64, and specificity of 80% to 4% 5%. Group B had 49 cases of MSU with 206 sites. The results showed that the sensitivity of MSU was 80.3 / 64, and the specificity of group A was slightly higher than that of group B, and the sensitivity and specificity of group A were higher than that of group B, and the sensitivity and specificity of group A were higher than that of group B, and the sensitivity of group A was higher than that of group B. However, t test P0.05. 0. 2A group measured the maximum cross sectional area of MSU 129.26 卤5. 16m / 2 group B group (308.47 卤32. 6 mm / min) test showed that the difference between the two groups was significant (P 0. 036 ~ 3 mm) in the display of small bone destruction, group B was significantly better than group A (4) in identifying small foci 3 / mm)MSU. The image can quickly identify and locate the lesions in group B, which is easy to miss diagnosis and miss judgment. Conclusion both DSCT gout and general have high sensitivity and specificity in detecting gout. The advantages of DSCT gout and general in rapid identification and localization of small uric acid lesions are in the display of small bone destruction. The combined use of the two methods is beneficial to the assessment of MSU load and bone and joint erosion in patients with gout.
【作者单位】：福建省立临床医学院;福建省立医院放射科;
【分类号】：R589.7;R816.6

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