CAJ | 학술논문

目的：对比研究痛风性关节炎的 X 线平片、CT 和 MRI 表现,并探讨临床资料与影像学表现的关系。方法选择33例患者的54个确诊为痛风性关节炎的关节为研究对象,上午空腹查血尿酸,下午记录临床资料,并做平片、CT 和 MRI 检查。影像表现的评价指标包括痛风石、骨质破坏、软组织肿胀、关节积液、滑膜增厚和骨髓水肿。统计分析方法包括卡方检验、独立样本 t 检验和逻辑回归分析。结果卡方检验分析不同检查方法下痛风石阳性的关节数(CT>平片、MR>平片, P<0.01),软组织肿胀(MR>CT>平片,P<0.01),关节积液(MR>CT, P<0.01)。此外,MRI 发现骨髓水肿35例,滑膜增厚50例。独立样本 t检验显示有痛风石的患者病程长于无痛风石的患者(P<0.01)。 Logstic 回归分析痛风石的致病因素,骨质破坏和病程入选(P<0.01)。结论对于痛风的早期诊断,MRI 优于 CT 和平片。痛风石和骨质破坏可能不会影响血尿酸水平。随着病程的延长,痛风石形成的几率也升高。痛风石的形成与骨质破坏可能是相互促进的关系。
목적：대비연구통풍성관절염적 X 선평편、CT 화 MRI 표현,병탐토림상자료여영상학표현적관계。방법선택33례환자적54개학진위통풍성관절염적관절위연구대상,상오공복사혈뇨산,하오기록림상자료,병주평편、CT 화 MRI 검사。영상표현적평개지표포괄통풍석、골질파배、연조직종창、관절적액、활막증후화골수수종。통계분석방법포괄잡방검험、독립양본 t 검험화라집회귀분석。결과잡방검험분석불동검사방법하통풍석양성적관절수(CT>평편、MR>평편, P<0.01),연조직종창(MR>CT>평편,P<0.01),관절적액(MR>CT, P<0.01)。차외,MRI 발현골수수종35례,활막증후50례。독립양본 t검험현시유통풍석적환자병정장우무통풍석적환자(P<0.01)。 Logstic 회귀분석통풍석적치병인소,골질파배화병정입선(P<0.01)。결론대우통풍적조기진단,MRI 우우 CT 화평편。통풍석화골질파배가능불회영향혈뇨산수평。수착병정적연장,통풍석형성적궤솔야승고。통풍석적형성여골질파배가능시상호촉진적관계。
Objective To make a comparison between the plain radiograph, CT, and MR findings of gouty arthritis and to analyse the relationship between clinical data and imaging findings. Methods Fifty-four joints of 33 patients with a confirmed diagnosis of gouty arthritis were included in this study. In the morning, the blood uric acid level of patients was tested before meal. In the afternoon, their clinical data were recorded and joints were examinated by plain radiography, CT, and MRI. The imaging findings were evaluated by tophi, bone erosion, soft tissue swelling, hydrarthrosis, synovial thickness, and bone oedema. The data was analyzed by Chi-square test, indepentdent-samples t test, and logistic regression. Results The Chi-square test was utilized to evaluate number of joints with tophi(CT>plain radiography, MR>plain radiography, P<0. 01), soft tissue swelling (MR>CT>plain radiography, P<0. 01), hydrarthrosis(MR>CT, P<0. 01). In addition, 35 joints had bone oedema and 50 joints had synovial thickness. The course of disease(tophi positive group vs tophi negative group, P<0. 01) was analyzed by indepentdent-samples t test. The tophi's causative agents including bone erosion and course of disease were analysed by logistic regression(P<0. 01). Conclusions MRI is superior to CT and plain radiography on the early diagnosis of gout. Tophi and bone erosion may not affect the blood uric acid level. With the progression of disease, the probability of tophi formation increases. The relationship between the formation of tophi and bone erosion may be interpromotied.