单源双能量CT低管电流扫描对痛风诊断价值的前瞻性研究  

Prospective study on the value of monophyletic double energy low-mAs CT scanning in diagnosis of gout

作　　者：高立栋[1] 侯金玲[2] 李生虎[1] GAO Lidong;HOU Jinling;LI Shenghu(Department of Radiology,Wuxi Traditional Chinese Medicine Hospital,Wuxi 214071,P.R.China;Department of Radiology,Wuxi People's Hospital,Wuxi 214023,P.R.China)

机构地区：[1]江苏省无锡市中医医院放射科,江苏无锡214071 [2]江苏省无锡市人民医院影像科,江苏无锡214023

出　　处：《医学影像学杂志》2020年第6期1091-1094,共4页Journal of Medical Imaging

基　　金：江苏省无锡市卫生健康委员会科研项目(编号:Q201910);江苏省无锡市中医医院青年科技创新托举计划项目(编号:ZYY20170008)。

摘　　要：目的探讨单源双能量CT(DECT)低管电流扫描成像技术对痛风结节中尿酸盐结晶的显示能力,并就单源DECT低管电流扫描在痛风患者中的应用可行性进行初步评估。方法将尿酸钠溶于水后析出制成100mg、10mg、1mg三种规格的尿酸盐晶体,并测量其大小。挑选整条新鲜猪后腿模拟人的下肢环境,将制成的尿酸盐晶体分多次置入猪腿骨旁及肌肉组织间的不同部位,抽吸排尽周围空气。将置入尿酸盐结晶的猪腿放置在CT扫描架,行DECT非增强扫描及薄层(0.75mm)重组。扫描分为常规剂量组及4组低管电流组(120mAs、80mAs、50mAs、20mAs),将原始数据输入syngo.via工作站中的痛风分析软件进行图像后处理,精确测量所显示尿酸盐结晶的大小,并进行统计学分析。结果常规剂量组、低管电流组(120mAs)及低管电流组(80mAs)测得的尿酸盐结晶大小与实际大小无统计学意义(P>0.05),获得了较满意的DECT图像。低管电流组(50mAs)及低管电流组(20mAs)测得的尿酸盐结晶大小与实际大小有统计学意义(P<0.05),所获得的DECT图像不满意,尿酸盐结晶的数目及大小均有较大差异。结论常规剂量组、低管电流组(120mAs)及低管电流组(80mAs)所使用的扫描参数能较准确地显示尿酸盐结晶的大小及形状,对实现单源DECT低管电流扫描来诊断痛风具有重要的参考价值及指导意义。Objective To explore the ability of monophyletic double energy(DECT)low-mAs CT scan imaging in displaying urate crystals in tophus as well as to preliminarily assess the application feasibility of the monophyletic DECT low-mAs scan in patients with gout.Methods The uric acid sodium urate crystal precipitation was made after soluble in water and made into three kinds of specifications of 100 mg,10 mg,1 mg,and then,its size was measured.The fresh meat of pig hind legs was chosen to simulate the environment of human.The urate crystals were imbedded into different parts of pig leg branch and muscle tissue for several times and the surrounding air was suctioned out fully.The pig leg imbedded with uric acid salt was placed on CT scans,then,non-enhanced DECT scanning and thin layer(0.75 mm)restructuring were conducted.The scanning was divided into routine dose group and 4 low-mAs groups(120 mAs,80 mAs,50 mAs,20 mAs).The original data were input into Dual-Energy GOUT image post-processing software.The accurate measurement of uric acid salt size and statistical analysis were performed.Results The measured urate crystal size and actual size in routine dose group,low-mAs group 1 and low-mAs group 2 had no statistical significance(P>0.05),and satisfactory DECT images were obtained.The urate crystal size and actual size in low-mAs(50 mAs)and low-mAs group(20 mAs)were statistically significant(P<0.05),the DECT images obtained were not satisfied,the size and the number of urate crystals had significant difference.Conclusion The scanning parameters used in routine dose group,low-mAs group 1 and low-mAs group 2 can accurately show the size and shape of urate crystals,which has important reference value and guiding significance to realize monophyletic double energy low-mAs CT scanning in the diagnosis of gout.

关 键 词：痛风 尿酸盐结晶 低管电流 体层摄影术 X线计算机 

分 类 号：R589.7[医药卫生—内分泌] R814.42[医药卫生—内科学]