中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2012年
4期
260-263,封3
,共5页
郑茗丹%水华%廖美焱%胡慧娟%覃慧群%许为佳%吴小燕
鄭茗丹%水華%廖美焱%鬍慧娟%覃慧群%許為佳%吳小燕
정명단%수화%료미염%호혜연%담혜군%허위가%오소연
痛风%诊断%双能量CT%尿酸盐结晶
痛風%診斷%雙能量CT%尿痠鹽結晶
통풍%진단%쌍능량CT%뇨산염결정
Gout%Diagnosis%Dual energy computed tomography%Urate crystal
目的 评价双能量CT对痛风的诊断价值.方法 对试验组的25例痛风患者双侧足部、踝关节、膝关节、手部、腕关节及肘关节行双能量CT扫描成像,统计尿酸盐结晶沉积病灶数,对出现临床症状的关节行X线检查.对患者四肢关节进行临床体检,统计临床病灶数目及部位.对照组的20例类风湿关节炎(RA)患者的受累关节及对侧关节行双能量CT扫描成像.同时检测所有患者的血尿酸、血肌酐、总胆固醇及甘油三酯水平.对比2组患者双能量CT检查结果与X线及临床体检之间的差异.统计学处理采用t检验和x2检验.结果 双能量CT检查中各关节发现病灶的病例数及比例分别为足部及踝关节23例(92％),膝关节17例(68％)、手与腕关节3例(12％)及肘关节1例(4％),足部及踝关节受累患者最多(P＜0.05).尿酸盐沉积病灶共184处,其中足与踝关节、膝关节、手与腕关节及肘关节的病灶数分别为107处(58.2％)、72处(39.1％)、4处(2.2％)、1处(0.5％),足部及踝关节中尿酸盐沉积病灶数最多(P＜0.01).临床统计病灶数为64处,仅占双能量CT发现病灶数的34.8％,差异具有统计学意义(P＜0.01).而X线检查仅6例患者发现骨质破坏等非特异性改变.试验组患者血尿酸、血肌酐及甘油三酯水平较对照组明显增高,差异具有统计学意义(P值分别为＜0.01,＜0.05,＜0.05).结论 双能量CT对痛风的诊断有重要的临床价值.
目的 評價雙能量CT對痛風的診斷價值.方法 對試驗組的25例痛風患者雙側足部、踝關節、膝關節、手部、腕關節及肘關節行雙能量CT掃描成像,統計尿痠鹽結晶沉積病竈數,對齣現臨床癥狀的關節行X線檢查.對患者四肢關節進行臨床體檢,統計臨床病竈數目及部位.對照組的20例類風濕關節炎(RA)患者的受纍關節及對側關節行雙能量CT掃描成像.同時檢測所有患者的血尿痠、血肌酐、總膽固醇及甘油三酯水平.對比2組患者雙能量CT檢查結果與X線及臨床體檢之間的差異.統計學處理採用t檢驗和x2檢驗.結果 雙能量CT檢查中各關節髮現病竈的病例數及比例分彆為足部及踝關節23例(92％),膝關節17例(68％)、手與腕關節3例(12％)及肘關節1例(4％),足部及踝關節受纍患者最多(P＜0.05).尿痠鹽沉積病竈共184處,其中足與踝關節、膝關節、手與腕關節及肘關節的病竈數分彆為107處(58.2％)、72處(39.1％)、4處(2.2％)、1處(0.5％),足部及踝關節中尿痠鹽沉積病竈數最多(P＜0.01).臨床統計病竈數為64處,僅佔雙能量CT髮現病竈數的34.8％,差異具有統計學意義(P＜0.01).而X線檢查僅6例患者髮現骨質破壞等非特異性改變.試驗組患者血尿痠、血肌酐及甘油三酯水平較對照組明顯增高,差異具有統計學意義(P值分彆為＜0.01,＜0.05,＜0.05).結論 雙能量CT對痛風的診斷有重要的臨床價值.
목적 평개쌍능량CT대통풍적진단개치.방법 대시험조적25례통풍환자쌍측족부、과관절、슬관절、수부、완관절급주관절행쌍능량CT소묘성상,통계뇨산염결정침적병조수,대출현림상증상적관절행X선검사.대환자사지관절진행림상체검,통계림상병조수목급부위.대조조적20례류풍습관절염(RA)환자적수루관절급대측관절행쌍능량CT소묘성상.동시검측소유환자적혈뇨산、혈기항、총담고순급감유삼지수평.대비2조환자쌍능량CT검사결과여X선급림상체검지간적차이.통계학처리채용t검험화x2검험.결과 쌍능량CT검사중각관절발현병조적병례수급비례분별위족부급과관절23례(92％),슬관절17례(68％)、수여완관절3례(12％)급주관절1례(4％),족부급과관절수루환자최다(P＜0.05).뇨산염침적병조공184처,기중족여과관절、슬관절、수여완관절급주관절적병조수분별위107처(58.2％)、72처(39.1％)、4처(2.2％)、1처(0.5％),족부급과관절중뇨산염침적병조수최다(P＜0.01).림상통계병조수위64처,부점쌍능량CT발현병조수적34.8％,차이구유통계학의의(P＜0.01).이X선검사부6례환자발현골질파배등비특이성개변.시험조환자혈뇨산、혈기항급감유삼지수평교대조조명현증고,차이구유통계학의의(P치분별위＜0.01,＜0.05,＜0.05).결론 쌍능량CT대통풍적진단유중요적림상개치.
Objective To evaluate the value of dual energy computed tomography (DECT) for the diagnosis of gout.Methods Twenty-fivc consccutive patients with gout were selected as the experimental group and 20 patients with rheumatoid arthritis (RA) were selected as the control group.DECT scans were performed for every patient (all peripheral joints for the experimental group and affected joints for the control group).And every patient with gout had X-ray examination of the involved joints.x2 test and t-test were used for statistical analysis.Results All 25 patients with gout showed urate deposits on their DECT scans,whereas none of 20 controls showed urate deposits (P＜0.01).DECT scans revealed a total of 184 areas of urate deposition in 25 patients,in which 107 (58.2％) were at feet and ankle,72 (39.1％) were at knees,4 (2.2％) were at hands and wrists,1 (0.5％) was at elbows,whereas physical examination only showed 64 areas of urate deposition,in which 38(59.4％) were at feet and ankle,24(37.5％) were at knees,2(3.1％) at hands and wrists,0 was at elbows(P＜0.01 ).Only 6 patients with gout showed nonspecific manifestations on X-ray.Conclusion DECT scans may have potential value for the diagnosis of gout since it could produce evident colour displays for urate deposits and help to identify subclinical tophus deposits.
