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.