CAJ | 학술논문

目的：利用双能量CT(Dual enegy CT，DSCT)痛风检测技术(gout)研究尿酸盐结晶(monosodium urate crystals,MSU)在痛风性关节炎分布的特征。方法回顾性分析43个经DSCT检查发现尿酸盐结晶沉积的足踝关节；把足踝关节划分为踝关节组、跖趾关节组、跗跖关节组、跗骨间关节组、趾骨间关节组及肌腱组，统计分析尿酸盐结晶累计的小关节或肌腱的数量，每个小关节或肌腱或韧带为一个单位，采用t检验分析分布的差异性。结果检出足踝关节尿酸盐结晶43例共290处，其中跖趾关节组71处，踝关节组56处，跗骨间关节组68处、跗跖关节组31例，趾骨间关节组50处，肌腱韧带组14处；六组数据经t检验两两比较：①跖趾关节组与跗跖关节组比较(P=0.0283＜0.05)，跗骨间关节组与跗跖关节组比较(P=0.0303＜0.05)，两组间差异均有统计学意义；②跖趾关节组与肌腱韧带组比较(P=0.003＜0.05)；踝关节组与肌腱韧带组比较(P=0.0005＜0.05)；跗骨间关节组与肌腱韧带组比较(P=0.0036＜0.05)；三组间差异均有统计学意义；③踝关节组与跗骨间关节组比较(P=0.4470＞0.05),跗跖关节组与肌腱韧带组比较(P=0.1072＞0.05),差异均没有统计学意义。结论足踝关节尿酸盐结晶常常沉积于关节周围、肌腱韧带等处，其中最常见于跖趾关节、踝关节和跗骨间关节这三类关节，其次为跗跖关节，最少沉积于肌腱及韧带等处。
목적：이용쌍능량CT(Dual enegy CT，DSCT)통풍검측기술(gout)연구뇨산염결정(monosodium urate crystals,MSU)재통풍성관절염분포적특정。방법회고성분석43개경DSCT검사발현뇨산염결정침적적족과관절；파족과관절화분위과관절조、척지관절조、부척관절조、부골간관절조、지골간관절조급기건조，통계분석뇨산염결정루계적소관절혹기건적수량，매개소관절혹기건혹인대위일개단위，채용t검험분석분포적차이성。결과검출족과관절뇨산염결정43례공290처，기중척지관절조71처，과관절조56처，부골간관절조68처、부척관절조31례，지골간관절조50처，기건인대조14처；륙조수거경t검험량량비교：①척지관절조여부척관절조비교(P=0.0283＜0.05)，부골간관절조여부척관절조비교(P=0.0303＜0.05)，량조간차이균유통계학의의；②척지관절조여기건인대조비교(P=0.003＜0.05)；과관절조여기건인대조비교(P=0.0005＜0.05)；부골간관절조여기건인대조비교(P=0.0036＜0.05)；삼조간차이균유통계학의의；③과관절조여부골간관절조비교(P=0.4470＞0.05),부척관절조여기건인대조비교(P=0.1072＞0.05),차이균몰유통계학의의。결론족과관절뇨산염결정상상침적우관절주위、기건인대등처，기중최상견우척지관절、과관절화부골간관절저삼류관절，기차위부척관절，최소침적우기건급인대등처。
Objective To study the use of Dual energy CT (DSCT) gout detection technology to evaluation of urate crystals in the distribution characteristics of the foot and ankle.Methods A total of 43 ankle joints which had been found uric acid salt were retrospective analysis by examinationed by DSCT and gout;The ankle joint including the ankle, plantar toe joints, Lisfranc's joints, tarsal joints, bone joints, and tendons, statistical analysis of the total number of urate crystals which accumulative in small joints or tendons, each small joints or tendon or ligamentr as a unit, using t test analysis of the distribution of the difference.Results 43 of ankle joint were show urate crystal deposition in 290, including 71 of plantar toe joint, ankle joint 56, Lisfranc's joints 31, the tarsal joint 68, joint between phalanges 49,and tendon and ligament 14 cases. Six groups of data for comparative analysis by t test (1)it show the differrents between plantar toe joint group of Lisfranc's joints group (P=0.0283<0.05)is statistical significance; and the difference between tarsal joint group of Lisfranc's joints group (P=0.0303<0.05)is statistical significance by t test; (2)it show the differrents between the plantar toe joints and ligaments tendons group(P=0.003<0.05), ankle and ligaments tendons group (P=0.0005<0.05), tarsal joints with ligaments tendons group (P=0.0036<0.05)all been statistically significant by t test;(3) it show the differrents between the ankle group with the tarsal joint group (P=0.4470>0.05), and between Lisfranc's joints with ligaments tendons group (P=0.1072>0.05)were no statistically significant differences.Conclusion Urate crystal in foot often deposition around ankle joints, tendons and ligaments , the most common plantar are toe joint, ankle joint and the joint , followed by Lisfranc's joints, and the least are around tendons and ligaments.