CAJ | 학술논문

目的：使用双源 CT 观察关节及周围组织的尿酸盐结晶，探索临床诊断痛风及鉴别诊断其他关节疾病。方法选择最近2周发作过单关节肿或关节痛患者19例，行双源 CT 检查，部分患者在 B 超下穿刺取关节液镜检。结果16例痛风患者发现有36处有尿酸盐结晶，好发于双侧足趾关节、近端指关节、远端指间关节周围、跖关节、胫骨下端，尿酸盐结晶易沉淀在近关节骨表面，肌肉、韧带等关节周边软组织，并且关节疼痛的部位与尿酸盐结晶沉淀部位一致，尿酸盐结晶的大小可以测量。结论双源 CT 可以清晰显示尿酸盐结晶，为无创检测手段，在鉴别诊断不明原因单关节肿痛方面有很高的临床价值。
목적：사용쌍원 CT 관찰관절급주위조직적뇨산염결정，탐색림상진단통풍급감별진단기타관절질병。방법선택최근2주발작과단관절종혹관절통환자19례，행쌍원 CT 검사，부분환자재 B 초하천자취관절액경검。결과16례통풍환자발현유36처유뇨산염결정，호발우쌍측족지관절、근단지관절、원단지간관절주위、척관절、경골하단，뇨산염결정역침정재근관절골표면，기육、인대등관절주변연조직，병차관절동통적부위여뇨산염결정침정부위일치，뇨산염결정적대소가이측량。결론쌍원 CT 가이청석현시뇨산염결정，위무창검측수단，재감별진단불명원인단관절종통방면유흔고적림상개치。
Objective To explore the value of non-invasive dual-energy CT in the diagnosis of gout and the differential diagnosis of other joint diseases by observing urate crystals surrounding tissues. Methods 19 patients, who experienced unilateral arthrocele or joint pain in the past two weeks, were enrolled into our study, dual-energy CT was performed in all patients and ultrasound-guided joint aspiration were performed in some patients, the location, quantity and size of urate crystals were analyzed by dual-energy CT. Results Thirty-six urate crystals were found in 16 gout patients, and the most common sites of deposition were bilateral inter-phalangeal joints of foot, proximal inter-phalangeal joints, tissues around distal interphalangeal <br> joint, metatarsal joints and the lower part of the tibia, the data indicated that urate crystals were more likely to deposit in the soft tissues around joints such as muscles, ligaments and so on, and the sites of deposition were consistent with the locations of arthralgia, the size of urate crystals could also be measured by dual-energy CT. Conclusion Urate crystals can be displayed by dual-energy CT, In addition, dual-energy CT is a non-invasive measure and it has great value in the differential diagnosis of joint diseases.