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目的:分析痛风性关节炎(GA)的双能量CT(DECT)影像学表现,探讨痛风性关节炎DECT的诊断价值。方法:回顾性总结GA 188例DECT、48例X线、17例MRI影像学表现,比较DECT双能量分析对痛风结节的检出率,比较急性期、非急性期痛风受累关节的DECT影像学表现。结果:GA急性期有65例、非急性期有123例,男∶女为13.5∶1,平均年龄(55.2±15.2)岁。DECT双能量分析前后对急性期痛风结节检出率分别为16.92%、69.23%,对非急性期痛风结节检出率分别为20.32%、90.24%,差异均有显著性,P<0.05。GA急性期与非急性期比较痛风结节、关节囊及关节面病变检出率均有显著性差异,P<0.05。MRI检出GA急性期、非急性期关节软骨病变率分别为80%、66.7%。结论:DECT双能量分析可以特异性检出痛风结节,显著提高痛风结节的检出率。DECT能较好地检出痛风关节病变,非急性期痛风结节、关节囊、关节面病变率均高于急性期关节病变。MRI可以敏感地检出关节软骨病变。X线能检出非急性期痛风关节的改变。
OBJECTIVE: To analyze the dual-energy CT (DECT) imaging of gouty arthritis (GA) and to evaluate the diagnostic value of DECT for gouty arthritis. Methods: 188 cases of DECT, 48 cases of X-ray and 17 cases of MRI were retrospectively reviewed. The detection rate of gonorrhea nodules by DECT dual-energy analysis was compared with DECT imaging of non-acute gout-affected joints which performed. Results: There were 65 cases of GA in the acute phase and 123 cases in the non-acute phase. The male and female were 13.5:1 and the average age was 55.2 ± 15.2 years old. The detection rates of gouty nodules in acute phase before and after DECT dual energy analysis were 16.92% and 69.23%, respectively. The positive rates of gouty nodules in non-acute phase were 20.32% and 90.24%, respectively, with a significant difference (P <0.05). There was a significant difference in the detection rate of gout nodules, joint capsule and articular surface between GA acute phase and non-acute phase, P <0.05. The detection rate of articular cartilage lesions in acute and non-acute phase of GA was 80% and 66.7% respectively. Conclusion: DECT dual-energy analysis can detect gout nodules and significantly increase the detection rate of gout nodules. DECT can better detect gout joint disease, non-acute gout nodules, joint capsule, articular surface lesions were higher than the acute joint disease. MRI can detect articular cartilage lesions sensitively. X ray can detect non-acute gout joint changes.