本文選題：痛風(fēng) + 尿酸鹽結(jié)晶　； 參考：《臨床放射學(xué)雜志》2016年03期

【摘要】：目的評(píng)價(jià)雙能量CT(DSCT)尿酸鹽結(jié)晶檢測(cè)技術(shù)(gout)和綜合技術(shù)(general)在痛風(fēng)檢測(cè)中的應(yīng)用價(jià)值。方法 (1)回顧性分析61例(64對(duì)部位)關(guān)節(jié)腫痛患者行DSCT掃描并分別經(jīng)gout及general兩種技術(shù)成像,所得圖像分別設(shè)為A、B組,統(tǒng)計(jì)兩組方法所顯示尿酸鹽結(jié)晶(MSU)數(shù)量,每一個(gè)小關(guān)節(jié)或一處肌腱、韌帶為一個(gè)計(jì)量,并用t檢驗(yàn)比較兩組圖像中痛風(fēng)診斷的敏感性和特異性。(2)選取長(zhǎng)徑5 mm MSU 30個(gè),在兩組圖像上分別測(cè)量同一MSU最大截面積,用t檢驗(yàn)比較兩組面積差異。(3)比較A、B兩組微小骨質(zhì)破壞的檢出。(4)比較兩組在小灶MSU數(shù)量(長(zhǎng)徑3mm)的檢出。結(jié)果 (1)共檢測(cè)61例(64對(duì)部位),符合2012年美國(guó)風(fēng)濕病學(xué)會(huì)痛風(fēng)關(guān)節(jié)炎診斷60例,非痛風(fēng)關(guān)節(jié)炎4例。其中A組MSU 59例,396處,敏感性92.18%(59/64),特異性80%(4/5)。B組MSU 49例,206處。顯示MSU敏感性80.3%(49/64),特異性60%(3/5)。A、B組均有高敏感性和特異性。A組敏感性和特異性較B組稍高,但t檢驗(yàn)P0.05。(2)A組測(cè)MSU最大截面積(129.26±5.16)mm~2;B組最大截面積(308.47±32.6)mm~2;t檢驗(yàn)顯示兩組面積差異有顯著性(P=0.036)。(3)在微小骨質(zhì)破壞(3 mm)顯示方面,B組明顯優(yōu)于A組;(4)在小灶(3 mm)MSU識(shí)別方面,A組圖像能快速識(shí)別和定位病灶;B組圖像容易漏診漏判。結(jié)論 DSCT gout和general技術(shù)對(duì)痛風(fēng)檢測(cè)均具有很高敏感性和較高特異性;gout技術(shù)優(yōu)勢(shì)在對(duì)尿酸鹽小病灶的快速識(shí)別和定位;general技術(shù)優(yōu)勢(shì)在顯示微小骨質(zhì)破壞。兩者聯(lián)合應(yīng)用有利于痛風(fēng)患者M(jìn)SU負(fù)荷評(píng)價(jià)和骨關(guān)節(jié)侵蝕評(píng)價(jià)。
[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 鹵5. 16m / 2 group B group (308.47 鹵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.
【作者單位】： 福建省立臨床醫(yī)學(xué)院;福建省立醫(yī)院放射科;
【分類(lèi)號(hào)】：R589.7;R816.6

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