双能量CT检测痛风患者尿酸盐沉积的初步应用  

Application of Dual-energy Computed Tomography for Detecting Uric Acid Deposition in Patients with Gout

作　　者：刘炜[1] 薛华丹[1] 曾学军[2] 孙昊[1] 王萱[1] 陈钰[1] 张云庆[1] 徐凯[1] 金征宇[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院普通内科,北京100730

出　　处：《中国医学科学院学报》2010年第6期645-648,719,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的评价双能量CT在痛风患者四肢关节尿酸盐沉积诊断中的作用。方法对37例临床诊断痛风的患者进行双手腕、双肘、双膝及双足踝关节双能量CT扫描,对照组为10例非痛风患者。双能量CTGOUT软件处理扫描图像后,由两名医师独立进行评价,比较病例组和对照组尿酸盐沉积的差异及双能量CT检出尿酸盐沉积部位与临床评估的差异。结果病例组17(46%)、6(16%)、10(27%)、33(89%)例患者分别在双手腕、双肘、双膝及双足踝关节CT检测到尿酸盐沉积,双足踝关节受累较其他关节多(P=0.000)。对照组无尿酸盐的沉积,两组差异具有统计学意义(P=0.000)。37例痛风患者尿酸盐沉积CT共发现297处,是临床估计病变部位的2.25倍(临床估计病变部位132处)(P=0.000)。结论双能量CT可以检测出痛风患者尿酸盐沉积,包括一些亚临床部位,但其检测的准确性有待进一步研究。Objective To assess the value of dual energy computed tomography （DECT） for the detection of uric acid （UA） deposition in patients with gout.Methods A total of 37 patients with tophaceous gout （including 8 crystal-proven cases） and 10 control patients （5 with unknown arthropathy,3 with rheumatoid arthritis,and 2 with osteoarthritis） were included.DECT was performed for all peripheral joints （wrists,hands,elbows,knees,ankles and feet）.Color coding was used to display the localization of UA deposition.Images were reviewed independently by two trained radiologists.Results With DECT,patients with gout were found to have UA deposits in hands and wrists 46% （17/37）,elbows 16% （6/37）,knees 27% （10/37）,ankles and feet 89% （33/37）.No UA deposit was observed in all 10 control patients （P=0.000）.Among the 37 patients with gout,the number of UA deposition sites detected by DECT （n=297） was 2.25 times of that detected by physical examinations （n=132） （P=0.000）.Conclusions DECT allows the visualization of UA deposition in gouty arthropathy.Even subclinical disease can be delineated with this technique.However,the accuracy of DECT requires further investigations.

关 键 词：CT 痛风性关节炎 尿酸结石 

分 类 号：R814.42[医药卫生—影像医学与核医学] R589.7[医药卫生—放射医学]