双能量CT在痛风性关节炎患者足踝关节尿酸盐结晶沉积分布情况观察中应用.docVIP

双能量CT在痛风性关节炎患者足踝关节尿酸盐结晶沉积分布情况观察中应用 　　[摘要] 目的 研究双能量CT在痛风性关节炎患者足踝关节尿酸盐结晶沉积分布情况观察中的应用。 方法 选择2015年2月～2016年2月在广西壮族自治区河池市人民医院行放射科经双能量CT（DECT）及西门子Gout识别软件检查发现足踝部尿酸盐结晶沉积病例80例，其中31例患者近期发生过足趾部单个和/或多个关节肿胀和/或疼痛，22例患者发生过踝关节肿胀和/或疼痛，27例为无症状高尿酸血症。对所有纳入患者DECT检测尿酸盐结晶（包括隐匿部位）分布的位置和数量，根据位置归类为踝关节，跗骨间关节、跗跖关节、跖趾关节、趾骨间关节、肌腱韧带六组，分别比较高尿酸血症患者与痛风足趾关节炎症急性发作患者或痛风踝关节炎症急性发作患者上述部位尿酸盐结晶的分布。 结果 痛风第一跖趾关节炎症急性发作患者跖趾关节尿酸盐结晶沉积跖趾关节50个（27.2%），显著高于高尿酸血症患者的23个（17%），差异有统计学意义（P 0.05）；痛风踝关节炎症急性发作患者踝关节尿酸盐结晶沉积60个（45.1%）显著高于高尿酸血症患者的45个（33.3%），差异有统计学意义（P 0.05）。 结论 DECT可清晰直观显示尿酸盐结晶的分布和数量，有助于痛风的诊断，尿酸盐沉积的部位和数量与痛风关节炎急性发作部位有关。 　　[关键词] 痛风；双能量CT；尿酸盐结晶；足踝关节分布 　　[中图分类号] R593.22 [文献标识码] A [文章编号] 1674-4721（2016）10（a）-0116-04 　　Application of dual energy computed tomography in distribution observation of the urate crystals in patients with gout 　　WEI Lin 　　Department of Radiology， Hechi Peoples Hospital， Guangxi Zhuang Autonomous Region， Hechi 547000， China 　　[Abstract] Objective To study the application of dual energy computed tomography （DECT） on distribution of urate crystals in ankle/feet joints of patients with gout. Methods A total of 80 patients with gout in ankle/foot joints from February 2015 to February 2016 examined by DECT and Siemens Gout recognition software in Hechi Peoples Hospital were selected， among which 31 patients with acute arthritis in metatarsophalangeal joints， 22 patients with acute arthritis in ankle joints， and 27 patients with hyperuricemia only. The distribution of urate crystals in ankles， the tarsal joints， tarsometatarsal， metatarsophalangeal joint， inter-phalangeal joints， tendons and ligaments were detected with PECT. The total number of urate crystals accumulated in these position were compared between the hyperuricemia patients and patients with acute arthritis in metatarsophalangeal joints， or patients with acute arthritis in ankle joints respectively. Results The total number of urate crystal deposition in patients with acute arthritis in metatarsophalangeal joints were 50 piece