Abstract：Objective To study the clinical application value of dual-energy CT (DECT) imaging in the diagnosis of gout. Methods 216 cases of clinically suspected gout patients admitted to our hospital from June 2020 to September 2022 were collected, and DECT was performed on the patients, who were divided into the observation group (with gout stones, n=108) and the control group (without gout stones, n=108) according to whether gout stones were present in the DECT results or not. The value of DECT in the detection of gout stones and the relationship between the detection rate of urate crystals and the blood uric acid level were analysed; the value of DECT in the diagnosis of gout and the evaluation of therapeutic efficacy was assessed by analysing the number of urate crystals detected by DECT before and after treatment and the blood uric acid level. Results In 216 patients with a clinical presumptive diagnosis of gout, 104 cases were finally clinically diagnosed with gout, and all were reviewed after treatment. In the observation group, 93 out of 108 cases were reviewed, and there was a significant positive correlation between the patients' blood uric acid level and the detection of urate crystals; the sensitivity of DECT for the diagnosis of gout was 89.42%, the specificity was 86.61%, and the accuracy of assessing efficacy was 100%. Conclusion DECT has very high sensitivity and specificity in the examination of tophi, so has basis of reference for clinical diagnosis of gout and evaluation of curative effect.
[1] 许红丽. 二维及彩色多普勒超声与传统影像学方法诊断痛风的对比分析[J]. 湖南师范大学学报 (医学版), 2018, 15(05): 161-164. [2] Neogi T, Jansen TL, Dalbeth N, et al.2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborativeinitiative[J]. Ann Rheum Dis, 2015, 74: 1789-1798. [3] Neogi T, Jansen TL, Dalbeth N, et al.2015 Gout Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative[J]. Arthritis Rheumatol, 2015, 67: 2557-2568. [4] Perez-Ruiz F, Naredo E.Imaging modalities and monitoring measures of gout[J]. Curr Opin Rheumatol, 2007, 19: 128-133. [5] Nicolaou S, Yong-Hing CJ, Galea-Soler S, et al.Dual-energy CT as a potential new diagyostic tool in the manage-ment of gout in the acute setting[J]. AJR Am J Roentgenol, 2010, 194: 1072-1078. [6] 陈佳杰, 张亚斌, 李博, 等. 双能量CT检测高尿酸患者尿酸盐结晶的临床价值[J]. 中国医学影像学杂志, 2018, 26(12): 924-927. [7] Dalbeth N, Aati O, Kalluru R, et al.Relationship between structural joint damage and urate deposition in gout: a plain radiography and dual-energy CT study[J]. Ann Rheum Dis, 2015, 74(6): 1030-1036. [8] Johnson TR, Weckbach S, Kellner H, et al.Clinical image: Dual-energy computed tomographic molecular imaging of gout[J]. Arthritisand Rheumatism, 2007, 56: 2809. [9] Yu Z, Mao T, Xu Y, et al.Diagnostic accuracy of dual-energy CT in gout: a systematic review and meta-analysis[J]. Skeletal Radiology, 2018, 47: 1587-4593. [10] Terkeltaub R.Update on gout: new therapeutic strategies and options[J]. Rheumatol, 2010, 6: 30-38. [11] 刘炜, 薛华丹, 曾学军, 等. 双能量CT检测痛风患者尿酸盐沉积的初步应用[J]. 中国医学科学院学报, 2010.32: 645-650. [12] 张惠娟, 林禾, 马明平, 等. 双能量CT双技术在痛风的应用价值[J]. 临床放射学杂志, 2016, 35: 432-436. [13] Happertz A, Hermann KA, Diekhoff T, et al.Systemic staging for urate eryfstal deposits with dual-energy CT and ultrasound in patients with suspected gout[J]. Rheumatol Int, 2014, 34: 763-771. [14] Mc Queen FM, Doyle A, Reves Q, et al . Bone erosions in patients with chronic gouty arthropathy are associated with tophi but not bone oedema or synovitis: new insights from a 3T MRI study[J]. Rheumatology (0xford), 2014, 53: 95-103.
2023, Vol. 20 
