CT平扫、X线检查及MR扫描技术在痛风关节炎中的诊断效能分析与对比  

Analysis and Comparison of Diagnostic Efficacy of CT Plain Scan,X-ray Examination and MR Scan Technology in Gouty Arthritis

作　　者：杨君 李笑石 黄家欣 惠文其 杨增会 YANG Jun;LI Xiao-shi;HUANG Jia-xin;HUI Wen-qi;YANG Zeng-hui(Department of Radiology,the Fifth Hospital of Xi'an,Xi'an 710000,Shaanxi Province,China;Department of Radiology,DaXing Hospital,Xi'an 710016,Shaanxi Province,China;Department of Radiology,Shenmu Hospital,Shenmu 719000,Shaanxi Province,China)

机构地区：[1]陕西省西安市第五医院,陕西西安710000 [2]陕西省西安大兴医院,陕西西安710016 [3]陕西省神木市医院,陕西神木719000

出　　处：《中国CT和MRI杂志》2023年第9期167-169,共3页Chinese Journal of CT and MRI

基　　金：陕西省自然科学基础研究计划;西安市卫生健康委员会中医药科研项目。

摘　　要：目的对比CT平扫、X线检查及MR扫描技术对于痛风关节炎的诊断效能。方法收集2021年11月至2022年7月我院痛风专科收治确诊为痛风性关节炎的210例患者。所有患者均按临床需求至少扫描过CT平扫、X线平片及MR平扫检查中的一种。其中A组为CT平扫检查,B组为X线平片检查,C组为MR平扫检查。统计3组检查的痛风关节炎阳性影像学征象检出率并分析影像学表现。结果在关节积液、痛风结节、骨质破坏、软组织肿胀等阳性征象中,三组患者累计关节135个,共检出征象364个,其中A组共检出阳性征象355个,B组共检出阳性征象191个,C组共检出阳性征象323个,三组检查灵敏度有统计学差异(P<0.05)。其中C组在关节积液、软组织肿胀的检出率最高;A组在软组织肿胀和骨质破坏的检出最高;而B组在骨质破坏检出中与A组无统计学差异,其余所有阳性征象检出均最低且有显著差异(P<0.05)。结论三种检查中MR对痛风关节炎影像学诊断效能最高,CT次之,X线平片最低。但MR检查费用较高,检查时间较长,因此在日常临床工作中应针对不同患者采用不同检查搭配,制定个性化检查影像学检查方案。Objective To compare the diagnostic efficacy of CT plain scan,X-ray examination and MR scan technology in gouty arthritis.Methods A total of 210 patients diagnosed with gouty arthritis admitted to the gout specialist of our hospital from January 2021 to July 2022 were collected.All patients were scanned at least one of CT plain,X-ray and MR plain scan according to clinical needs.Among them,group A was CT plain scan examination,group B was X-ray plain film examination,and group C was MR plain scan examination.The detection rates of positive imaging signs of gouty arthritis in the three groups were counted and the imaging manifestations were analyzed.Results Among the positive signs such as joint effusion,gouty nodules,bone destruction,and soft tissue swelling,there were 135 joints in the three groups,and a total of 364 signs were detected,of which group A had a total of 135 joints.355 positive signs were detected,191 positive signs were detected in group B,and 323 positive signs were detected in group C,and the sensitivity of the three groups was statistically different(P<0.05).Among them,group C had the highest detection of joint effusion,soft tissue swelling,group A had the highest detection of soft tissue swelling and bone destruction;and group B had the highest detection of bone destruction compared with group A.Statistical difference,all other positive signs were the lowest and had significant difference(P<0.05).Conclusion Among the three examinations,MR has the highest imaging diagnostic performance for gouty arthritis,followed by CT,and X-ray is the lowest.However,the cost of MR examination is high and the examination time is long.Therefore,different examination collocations should be used for different patients in daily clinical work,and a personalized imaging examination plan should be developed.

关 键 词：痛风 类风湿关节炎 痛风性关节炎 双能量CT 鉴别诊断 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.22[医药卫生—诊断学]