双能量CT对痛风性膝关节炎的诊断价值  

Diagnostic Value of Dual-source CT Dual-energy Technique in Gouty Knee Arthritis

作　　者：蒲学佳 胡元明[1] 吕涵青[1] 廖炯[1] 段柯[1] 林建真 Pu Xuejia;Hu Yuanming;Lv Hanqing;Liao Jiong;Duan Ke;Lin Jianzhen(Department of Radiology,Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong 518033)

机构地区：[1]深圳市中医院放射科,广东深圳518033

出　　处：《现代医用影像学》2021年第7期1189-1192,1198,共5页Modern Medical Imageology

摘　　要：目的:探讨双能量CT(DECT)对痛风性膝关节炎的诊断价值。方法:回顾性分析122例临床拟诊痛风性膝关节炎患者162个膝关节的DECT图像。将尿酸盐结晶沉积部位分为韧带组、肌腱组、半月板/软骨组、关节囊/髌上囊组,对尿酸盐结晶的分布特点进行分析。结果:122例患者162个膝关节均完成了DECT检查。其中109例病人147个膝关节DECT检查有尿酸盐沉积,13例病人15个膝关节DECT检查未见尿酸盐沉积。DECT显示膝关节的韧带、肌腱、半月板、软骨、关节囊、髌上囊可见尿酸盐结晶沉积。共有299条韧带、215条肌腱、137处半月板或软骨、84处膝关节囊或髌上囊可见尿酸盐结晶沉积。尿酸盐结晶在韧带组中常见沉积部位是后交叉韧带(51.27%)和前交叉韧带(35.21%),肌腱组中常见沉积部位是腘肌腱(61.07%)和股四头肌腱(31.49%),半月板及软骨组中常见沉积部位是外侧半月板(35.84%)和内侧半月板(29.67%),关节囊及髌上囊组沉积情况是膝关节囊(29.04%)和髌上囊(22.87%)。结论:DECT能够清晰的显示痛风性膝关节炎尿酸盐结晶的分布特点,能为痛风性膝关节炎的临床诊治提供参考依据。Objective:To explore the diagnostic value of dual-energy CT(DECT)for gouty knee arthritis.Methods:The DECT images of 162 knee joints in 122 patients with clinically diagnosed gouty knee arthritis were retrospectively analyzed.The sites of urate crystal deposition were divided into ligament group,tendon group,meniscus/cartilage group,articular capsule/suprapatellar capsule group,and the distribution characteristics of urate crystal were analyzed.Results:A total of 162 knee joints of 122 patients completed DECT examination.Urate deposition was found in 147 knee DECT of 109 patients,and no urate deposition was found in 15 knee DECT of 13 patients.DECT showed urate crystal deposition in ligaments,tendons,meniscus,cartilage,articular capsule,and suprapatellar capsule of the knee.There were 299 ligaments,215 tendons,137 menisci or cartilage,84 knee joint capsules,or supracondylar capsules with urate crystal deposits.The common deposition sites of urate crystals in the ligament group were the posterior cruciate ligament(51.27%)and anterior cruciate ligament(35.21%).The common deposition sites in the tendon group were the popliteal tendon(61.07%)and the quadriceps tendon(31.49%).The common deposition sites in the meniscus and cartilage groups are the lateral meniscus(35.84%)and the medial meniscus(29.67%).The articular capsule and the epicondyle group are deposited in the knee capsule(29.04%)and the epicondyle(22.87%).Conclusion:DECT can clearly show the distribution characteristics of urate crystals in gouty knee arthritis,which can provide reference for the clinical diagnosis and treatment of gout knee arthrtis.

关 键 词：双能量CT 膝关节 痛风 尿酸盐结晶 

分 类 号：R589.7[医药卫生—内分泌] R816.8[医药卫生—内科学]