剪切波弹性成像技术鉴别痛风性关节炎与非痛风性关节炎的可行性研究  

Study on the feasibility of shear wave elastography in distinguishing gouty arthritis from non-gouty arthritis

作　　者：杨慧慧 黄小莉[1] 郑红雨[1] 蓝蓓 曾欣欣 蒙伟宇 Yang Huihui;Huang Xiaoli;Zheng Hongyu;Lan Bei;Zeng Xinxin;Meng Weiyu(Department of Ultrasound,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning530021,China;GuangxiMedical University,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院超声科,南宁530021 [2]广西医科大学,南宁530021

出　　处：《广西医科大学学报》2021年第7期1423-1426,共4页Journal of Guangxi Medical University

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题资助项目(No.Z20190733)。

摘　　要：目的:观察剪切波弹性成像(SWE)弹性模量在痛风性关节炎(GA)与非痛风性关节炎(NGA)中的差异,为临床提供一种快速便捷的鉴别诊断GA与NGA的方法。方法:选取广西壮族自治区人民医院2020年2~12月收治的GA患者82例(GA组,109个关节)和NGA患者25例(NGA组,51个关节)进行超声检查,根据关节滑膜的不同超声表现将GA组分为无聚集体组、聚集体组及痛风石组。应用SWE测量GA组和NGA组关节滑膜的弹性模量平均值(Emean)、最大值(Emax)、最小值(Emin)和弥散度(ESD),分析比较两组间及GA组不同亚组之间各参数的差异;绘制受试者工作曲线(ROC曲线),计算GA组与NGA组患者弹性模量的截断点。结果:GA组与NGA组的Emean、Emax、Emin及ESD值的比较差异均有统计学意义(P<0.001);GA组不同亚组之间各参数的差异均具有统计学意义(P<0.001);以Emax=68.50 kPa、Emean=42.95 kPa、Emin=30.35 kPa作为诊断GA的截断点,ROC曲线下面积(AUC)分别为0.906、0.884、0.811;灵敏度分别为89.5%、89.5%、84.2%,特异度分别为80.4%、72.5%、74.5%。结论:剪切波弹性成像对GA与NGA有一定的鉴别诊断价值。Objective:To observe the difference in elastic modulus of shear wave elastography(SWE)between gouty arthritis(GA)and non-gouty arthritis(NGA),and provide a quick and convenient method for clinical diagnosis of GA and NGA.Methods:There were 82 GA patients(the GA group,109 joints)and 25 NGA patients(the NGA group,51 joints)enrolled in the study.According to the different ultrasound manifestations of the joint synovium,the GA group was sub-classified as non-aggregatedgroup,aggregate group,and tophus group.SWE was used to measure the average(Emean),maximum(Emax),minimum(Emin)and dispersion(ESD)of the joint synovium.The cut-off point of the elastic modulus was calculated.Results:The differences in Emean,Emax,Emin,and ESD values between the GA group and the NGA group were statistically significant(P<0.001).The differences in parameters between the different subgroups of GA were statistically significant(P<0.001).Emax=68.50,Emean=42.95,Emin=30.35 kPa were used as cut-off points for the diagnosis of GA.The area under the ROC curve(AUC)were 0.906,0.884,and 0.811,respectively.The sensitivity was 89.5%,89.5%,and 84.2%,and the specificity was 80.4%,72.5%,and 74.5%.Conclusion:Shear wave elastography has a certain value in the differential diagnosis of GA and NGA.

关 键 词：痛风性关节炎 剪切波弹性成像 弹性模量值 

分 类 号：R593.1[医药卫生—内科学]