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双源CT在痛风诊断中的临床价值

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目的:评估双源CT在痛风诊断中的临床价值;方法:纳入2016年12月~2022年10月弋矶山医院风湿免疫科住院且临床诊断痛风的患者资料,将符合2015年美国风湿病学会(ACR)/欧洲风湿病联盟(EULAR)痛风分类标准(双源CT结果除外)作为诊断痛风的标准,分析双源CT在痛风诊断中的准确性,不同病程痛风患者双源CT检查阳性率的差异及出现骨破坏的差异.结果:共纳入125例临床诊断痛风且行关节双源CT检查的患者资料,其中男性117例,女性8例,中位病程5年,符合2015年ACR/EULAR分类标准的患者共109例,与该标准相比,双源CT诊断的灵敏度和特异度分别为88.07%和81.25%;阳性预测值和阴性预测值分别为96.97%和50.00%;受试者工作特征(ROC)曲线下面积为0.847.双源CT阳性率高于骨质破坏阳性率(P<0.001).病程5年以上患者的双源CT阳性率和骨质破坏阳性率均高于≤5年的患者(P<0.05);结论:双源CT检查在痛风诊断中有较高的特异度和灵敏度,有助于临床痛风的诊断,且随着病程的延长,双源CT诊断的灵敏度和特异度更高.
Clinical importance of dual-energy CT in diagnosis of gout
Objective:To assess the clinical value of dual-energy computed tomography(DECT)in the diagnosis of gout.Methods:This retrospective study was performed in patients clinically diagnosed as gout and treated in our hospital between December 2016 and October 2022.The diagnosis criteria were based on the 2015 American College of Rheumatology(ACR)/European League for Rheumatism(EULAR)classification(except DECT findings).Finally,the data were analyzed for the accuracy of DECT in the diagnosis of gout as well as the difference of positive DECT findings and incidence of bone erosion in patients with different degree of gout.Results:125 patients(117 males and 8 females)clinically diagnosed with gout who underwent joint DECT examination were included.The median disease duration was 5 years.One hundred and nine patients met the ACR/EULAR classification criteria.The sensitivity and specificity of DECT diagnosis were 88.07%and 81.25%,respectively,compared to the classification criteria.The positive and negative predictive value was respectively 96.97%and 50.00%.The area under the curve was 0.847.The positive rate of DECT was significantly higher than that of bone erosion(P<0.001),and the positive rate of DECT and bone erosion were significantly higher in patients with disease duration over 5 years than in those with disease duration ≤5 years(P<0.05).Conclusion:DECT is clinically helpful to the diagnosis of gout,for it can lead to higher specificity and sensitivity.Besides,the sensitivity and specificity of DECT can be much higher in patients with prolonged disease duration.

dual-energy CTgoutdiagnosis

陈兰芳、俞咏梅、张霞、强孚勇、宣丹、徐亮

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皖南医学院第一附属医院弋矶山医院风湿免疫科,安徽 芜湖 241001

皖南医学院第一附属医医学影像中心,安徽 芜湖 241001

双源CT 痛风 诊断

芜湖市科技计划项目

2021cg41

2024

皖南医学院学报
皖南医学院

皖南医学院学报

CSTPCD
影响因子:0.695
ISSN:1002-0217
年,卷(期):2024.43(5)
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