高频超声对痛风性关节炎的诊断效能及与其他影像学检查的对比研究  

Diagnostic efficiency of high frequency ultrasound for gouty arthritis and detection rate comparison with other imaging methods

作　　者：唐小兰[1] 唐远姣[1] 向茜[1] 邱逦[1] 

机构地区：[1]四川大学华西医院超声科,成都610041

出　　处：《中华医学超声杂志（电子版）》2016年第4期249-253,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金资助项目(81271585)

摘　　要：目的评估高频超声(HFUS)对痛风性关节炎(GA)的诊断效能,并与其他影像学检查诊断符合率进行比较。方法回顾性分析2011年1月至2015年12月经四川大学华西医院临床确诊并有影像学资料的GA患者285例,其中100例行超声检查,将其与同期临床诊断为其他类型关节炎(对照组)患者40例的超声检查结果进行诊断性实验,计算ROC曲线下面积(AUC),评价HFUS诊断效能;并分析X线、CT、双能量CT(DECT)、MRI检查对GA患者的诊断符合率,与HFUS进行对比分析。结果 HFUS诊断GA的敏感度、特异度、阳性预测值、阴性预测值分别为89.0%(89/100)、95.0%(38/40)、97.8%(89/91)、77.6%(38/49),ROC曲线下面积为0.877。285例GA患者中,行X线、CT、DECT、MRI检查者分别为214例、112例、54例、64例,其诊断符合率分别为40.7%(87/214)、56.3%(63/112)、92.6%(50/54)、62.5%(40/64),HFUS的诊断符合率为89.0%,高于X线、CT、MRI,且差异均具有统计学意义(χ2=64.665、27.924、16.325,P值均<0.05),与DECT间诊断符合率比较,差异无统计学意义(χ2=0.515,P>0.05)。结论 HFUS诊断GA的诊断效能高,诊断符合率明显高于X线、CT及MRI,与DECT基本一致,可用于GA诊断。Objective To evaluate the diagnostic efficiency of high frequency ultrasound（HFUS） for gouty arthritis（GA）, and compare diagnostic coincidence rate with other imaging methods. Methods Retrospectively analysis imaging data of 285 cases clinically diagnosed as GA, of which 100 patients received HFUS examination. Select 40 patients with other arthritis as control group to conduct a diagnostic test, calculate the area under the receiver operating characteristic（ROC） curve（AUC） and evaluate diagnostic efficiency of HFUS. Analysis the results of X-ray, CT, MRI and Dual-energy CT（DECT） of 285 GA patients, and compare the diagnostic coincidence rate with HFUS. Results The sensitivity, specificity, positive predictive value, negative predictive value of HFUS were 89.0%（89/100）, 95.0%（38/40）, 97.8%（89/91） and 77.6%（38/49）. The AUC was 0.877. In 285 GA patients, cases received X-ray, CT, DECT and MRI were 214 cases, 112 cases, 54 cases and 64 cases, respectively, and the diagnostic coincidence rate was 40.7%（87/214）, 56.3%（63/112）, 92.6%（50/54） and 62.5%（40/64）, with the diagnostic coincidence rate of HFUS was 89.0%（89/100）. The coincidence rate of HFUS was higher than those of X-ray, CT and MRI and the difference was statistically significant（χ2=64.665, 27.924 and 16.325, all P 〈0.05）. While there was no statistically significant difference between HFUS and DECT（χ2=0.515, P 〉0.05）. Conclusions HFUS has high efficiency in the diagnosis of GA. The diagnostic coincidence rate was significantly higher than those of X-ray, CT and MRI and was consistent with that of DECT. HFUS is preferred in diagnosing GA.

关 键 词：痛风 关节炎 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]