摘要
目的探讨双能量CT(DECT)检测高尿酸患者尿酸盐结晶的临床价值。资料与方法回顾性分析2014年1月-2017年12月空军军医大学唐都医院风湿免疫科行DECT检查的住院患者67例,并根据临床诊断分为痛风组53例与非痛风组14例,比较两组患者的双能量影像特征及血尿酸值,分析DECT检测尿酸结晶的敏感度、特异度、阳性预测值及阴性预测值。结果两组患者性别、年龄、血尿酸值、CT容积剂量指数和剂量长度乘积比较,差异均无统计学意义(P>0.05)。DECT检测尿酸盐结晶石的敏感度为86.8%、特异度为92.9%、阳性预测值为97.9%、阴性预测值为65.0%。痛风组尿酸盐结晶阳性率高于非痛风组,差异有统计学意义(χ~2=33.5,P<0.001)。受试者工作特性曲线下面积为0.90(95%CI 0.80～0.99)。结论 DECT可清晰显示结晶沉积及范围、骨质破坏情况,对高尿酸患者的尿酸盐结晶检测、诊断及鉴别等具有较高的敏感性、特异性和可靠性,对于痛风病情诊断具有重要价值。
Purpose To investigate the clinical value of dual-energy CT(DECT)in detecting urate crystals in patients with hyperuricemia.Materials and Methods Sixty-seven inpatients who underwent DECT examination in the Department of Rheumatology and Immunology,Tangdu Hospital of the Fourth Military Medical University from January2014to December2017were retrospectively analyzed,and were divided into gout group(n=53)and non-gout group(n=14)as per clinical diagnosis.The dual-energy image features and blood uric acid value were compared between the two groups.The sensitivity,specificity,positive predictive value and negative predictive value of dual-energy CT for detecting uric acid crystal were analyzed.Results The difference in respect of gender,age,blood uric acid value,CT dose index of volume and dose-length product between the two groups showed no statistical significance(P>0.05).In detecting urate crystals with DECT,the sensitivity was86.8%,specificity92.9%,positive predictive value97.9%,and negative predictive value65.0%.The positive rate of urate crystallization in the gout group was higher than that in the non-gout group,the difference of which was statistically significant(χ^2=33.5,P<0.001),with area under ROC curve of0.90(95%CI0.80-0.99).Conclusion The dual-energy CT technique can clearly display crystal deposition and range,bone destruction,and has high sensitivity,specificity and reliability for the detection,diagnosis and identification of urate crystals in patients with high uric acid,featuring essential value in gout diagnosis.
作者
陈佳杰
张亚斌
李博
雷学斌
崔光彬
CHEN Jiajie;ZHANG Yabin;LI Bo;LEI Xuebin;CUI Guangbin(Department of Radiology,Tangdu Hospital,Air Force Military Medical University,Xi'an 710038,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2018年第12期924-927,共4页
Chinese Journal of Medical Imaging
