目的: 研究双能量CT（DECT）成像在痛风诊断中的临床应用价值。方法: 收集2020年6月—2022年9月我院收治的临床疑似痛风患者216例,对患者行DECT检查,根据DECT检查结果是否有痛风石,将患者分为观察组（有痛风石,n=108）和对照组（无痛风石,n=108）。分析DECT在痛风石检出中的价值,尿酸盐结晶检出率与血尿酸水平的关系;通过分析治疗前后DECT检查出的尿酸盐结晶数目、血尿酸水平评判DECT在痛风诊断及疗效评估中的价值。结果: 216例临床拟诊为痛风的患者,104例最终临床确诊为痛风,均经治疗后复查。观察组108例中93例复查,患者血尿酸水平与尿酸盐结晶检出呈显著正相关;DECT对痛风诊断敏感度为89.42%,特异性为86.61%,对疗效评估准确率100%。结论: DECT对痛风石的检出有较高的敏感性和特异性,对临床诊断痛风及疗效评估具有明显价值。
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.
关键词
双能量CT /
痛风 /
血尿酸 /
尿酸盐结晶
Key words
dual energy CT /
gout /
serum uric /
urate crystals
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参考文献
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基金
湖南省卫生健康委员会科研项目（202109010020）
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