摘要
目的 痛风性关节炎尿酸盐沉积患者鉴别诊断中运用X线辅助计算机断层扫描技术的临床价值。方法 选取我院收治的80例痛风性关节炎患者,选取时间均在2019年12月至2020年12月,利用X线辅助计算机断层技术技术检查患者的病变位置,并借助痛风分析系统,对患者尿酸盐沉积位置、数目、体积等加以分析,与临床鉴别诊断相互对比。结果 80例患者接受关节液检测或者痛风石穿刺活检均存在尿酸盐沉积;双能量CT扫描可发现尿酸盐沉积患者共计72例,8例为阴性,双能量CT诊断的灵敏度达到90.0%(72/80);双能量CT检测共鉴别诊断出278处尿盐酸沉淀,临床医生评价分析痛风结节沉积位置66处,双能量CT检出数目是临床评价分析的4.21倍;双能量CT鉴别诊断急性痛风患者共计36例,占比45.0%,慢性痛风患者共计44例,占比55.0%,临床评价急性痛风共计28例,占比35.0%,慢性痛风患者共计52例,占比65.0%,组间对比差异无统计学意义(P>0.05);双能量CT扫描可观察到尿酸盐结晶呈现不规则状,部分以点状为主,80例痛风性关节炎患者尿尿酸盐结晶沉积最长直径<5 mm,结晶共有177处,占比63.7%,直径达到5~10 mm共有72处,占比25.9%,直径>10 mm共有29处,占比10.4%。结论 在痛风性关节炎尿酸盐沉积患者鉴别诊断过程中,X线辅助计算机断层扫描技术有着的检出率,且和病理穿刺结果基本相同,明显高于临床鉴别评估,能够做出正确的急慢性发作期判断,为痛风性关节炎尿酸盐沉积患者的临床治疗提供可靠的依据。
Objective To evaluate the clinical value of X-ray-assisted computed tomography in the differential diagnosis of urate deposition in patients with gouty arthritis. Methods Eighty patients with gouty arthritis treated in our hospital from December 2019 to December 2020, the lesion location of the patient was detected by dual energy CT and with the help of gout analysis system, the location, number and volume of urate deposition were analyzed and compared with clinical differential diagnosis. Results Urate deposition was found in 80 patients who underwent joint fluid test or gout stone biopsy. A total of 72 patients with urate deposition could be found by dual energy CT scan, 8cases were negative, The sensitivity of dual energy CT was 90.0%(72/80). A total of 278 urinary hydrochloric acid precipitates were identified by dual energy CT, clinicians evaluated and analyzed 66 deposition sites of gout nodules,the detection number of dual energy CT was 4.21 times higher than that of clinical evaluation analysis;There were 36cases with acute gout diagnosed by dual energy CT, accounting for 45.0%. There were 44 patients with chronic gout,accounting for 55.0%, there were 28 cases with acute gout,accounting for 35.0%, there were 52 patients with chronic gout, accounting for 65.0%,there was no significant difference between groups(P>0.05);The irregular shape of urate crystal can be observed by dual energy CT scanning,some of them were mainly punctate, the longest diameter of urinary hydrochloric acid crystal deposition in 80 patients with gouty arthritis was less than 5 mm,there are 177 crystals in total,accounting for 63.7%,there were 72 places with a diameter of 5~10 mm, accounting for 25.9%, there were 29places with a diameter of more than 10mm, the proportion reached 10.4%. Conclusion In the differential diagnosis of patients with urate deposition in gouty arthritis, X-ray assisted computed tomography had a significant detection rate and the results are basically the same as those of pathological puncture, significantly higher than clinical differential evaluation, can make correct judgment of acute and chronic attack period, to provide a reliable basis for the clinical treatment of patients with urate deposition in gouty arthritis.
作者
张谦
时光丽
韩萌
李怡萱
孟庆良
Zhang Qian;Shi Guangli;Han Meng;Li Yixuan;Meng Qingliang(Department of Radiology,Henan Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China;不详)
出处
《实用医学影像杂志》
2022年第5期470-473,共4页
Journal of Practical Medical Imaging
基金
国家自然科学基金(81874456)。
