Analysis of the Application Value of Dual-source CT and MRI in the Diagnosis of Gouty Arthritis

doi:10.7517/issn.1674-0475.191003

Abstract

Abstract: 100 patients with gouty arthritis who were treated in our hospital from May 2017 to May 2019 were enrolled. All patients underwent dual-source CT and MRI. In this study, we compared the positive diagnostic rate and the diagnostic sensitivity of dual-source CT and MRI, as well as the image differences in two methods(including tophus, joint bone damage, articular cartilage damage, joint effusion, peripheral edema, synovial damage and urate crystal). The aim was to explore the value of dual-source CT and MRI in the diagnosis of patients with gouty arthritis. The results showed that the positive rate and diagnostic sensitivity of dual-source CT were higher than that of MRI, and the difference was statistically significant. Dual-source CT had a higher detection rate for tophus and bone destruction than MRI, and the difference was statistically significant. Dual-source CT has high specificity in detecting urate crystals. In examination of joint effusion, synovium and cartilage change, MRI has higher detection rates than dual-source CT, and the difference was statistically significant. The above results indicate that dual-source CT is specific in diagnosing urate crystals. The application value of dual-source CT in the diagnosis of gouty arthritis is higher than MRI.

Key words: gouty arthritis, dual source CT, MRI

CLC Number:

LI Chunlei, QING Guangjun, WANG Rongfen, PENG Ke. Analysis of the Application Value of Dual-source CT and MRI in the Diagnosis of Gouty Arthritis[J]. Imaging Science and Photochemistry, 2020, 38(2): 344-349.

References

[1] Tausche A K, Jansen T L, Schröder H E, et al. Gout——current diagnosis and treatment[J]. Deutsches Ärzteblatt International, 2009,106(34-35):549-555.
[2] Khanna D, Fitzgerald J D, Khanna P P, et al. 2012 American college of rheumatology guidelines for management of gout. Part 1:systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia[J]. Arthritis Care & Research, 2012,64(10):1431-1446.
[3] Singh J A, Strand V. Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans[J]. Annals of the Rheumatic Diseases, 2008,67(9):1310-1316.
[4] Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part Ⅱ:management. Report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT)[J]. Annals of the Rheumatic Diseases, 2006,65(10):1312-1324.
[5] Zhu Y, Pandya B J, Choi H K. Prevalence of gout and hyperuricemia in the US general population:the national health and nutrition examination survey 2007-2008[J]. Arthritis and Rheumatism, 2011,63(10):3136-3141.
[6] Cronstein B N, Sunkureddi P. Mechanistic aspects of inflammation and clinical management of inflammation in acute gouty arthritis[J]. Journal of Clinical Rheumatology, 2013,19(1):19-29.
[7] Ko K H, Hsu Y C, Lee H S, et al. Tophaceous gout of the knee:revisiting MRI patterns in 30 patients[J]. Journal of Clinical Rheumatology, 2010,16(5):209-214.
[8] Wu H, Xue J, Ye L, Zhou Q, et al. The application of dual-energy computed tomography in the diagnosis of acute gouty arthritis[J]. Clinical Rheumatology, 2014,33(7):975-979.
[9] Wallace S L, Robinson H, Masi A T, et al. Preliminary criteria for the classification of the acute arthritis of primary gout[J]. Arthritis and rheumatism, 1977,20(3):895-900.
[10] Zhang Z, Zhang X, Sun Y, et al. New urate depositions on dual-energy computed tomography in gouty arthritis during urate-lowering therapy[J]. Rheumatology International, 2017,37(8):1365-1372.
[11] Popp J D, Bidgood W D, Edwards N L. Magnetic resonance imaging of tophaceous gout in the hands and wrists[J]. Se-minars in Arthritis and Rheumatism,1996,25(4):282-289.
[12] 王勇, 刘斌. 双源CT对临床疑似痛风性关节炎的诊断价值[J]. 现代医用影像学, 2016,25(3):426-429. Wang Y, Liu B. Dual source CT in diagnosis of clinically suspected gouty arthritis[J]. Modern Medical Imageology, 2016,25(3):426-429.
[13] 刘悦, 张贺诚, 鲁春磊, 等. 痛风性关节炎X线和双源CT诊断价值比较分析[J]. 中国CT和MRI杂志, 2017,15(10):119-121. Liu Y, Zhang H C, Lu C L, et al. Diagnostic value comparison of X-ray and dual-energy imaging in gouty arthritis[J]. Chinese Journal of CT and MRI, 2017,15(10):119-121.
[14] Magnus P, Armstrong B, McCall M. A comparison of populations self-selected and randomly selected for coronary risk factor screening[J]. Preventive Medicine, 1983,12(2):340-350.
[15] Choi H K, Mount D B, Reginato A M. Pathogenesis of gout[J]. Annals of Internal Medicine, 2005,143(7):499-516.
[16] 刘洁, 刘安, 景香香.高频超声对高尿酸血症患者并发痛风性关节炎的诊断价值[J]. 中国老年学杂志, 2019,39(12):2947-2949. Liu J, Liu A, Jing X X. The diagnostic value of high frequency ultrasonography in patients with hyperuricemia and gouty arthritis[J].Chinese Journal of Gerontology, 2019,39(12):2947-2949.
[17] Chowalloor P V, Siew T K, Keen H I. Imaging in gout:a review of the recent developments[J]. Therapeutic Advances in Musculoskeletal Disease, 2014,6(4):131-143.
[18] Gordon C, Swan A, Dieppe P. Detection of crystals in synovial fluids by light microscopy:sensitivity and reliability[J]. Annals of the Rheumatic Diseases, 1989,48(9):737-742.
[19] Nicolaou S, Yong-Hing C J, Galea-Soler S, et al. Dual-energy CT as a potential new diagnostic tool in the management of gout in the acute setting[J]. American Journal of Roentgenology, 2010,194(4):1072-1078.
[20] McQueen F M, Doyle A, Dalbeth N. Imaging in gout:what can we learn from MRI, CT, DECT and US?[J]. Arthritis Research & Therapy, 2011,13(6):246.
[21] 陈维翠, 成官迅, 梁文倩, 等. DSCT双能量成像检测尿酸盐结晶沉积的临床应用价值[J]. 中国CT和MRI杂志, 2013,11(2):53-56, 2. Chen W C, Cheng G X, Liang W Q, et al. Application of dual energy computed tomography for detecting uric acid deposition[J]. Chinese Journal of CT and MRI, 2013,11(2):53-56, 2.
[22] Cimmino M A, Zampogna G, Parodi M, et al. MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack[J]. Annals of the Rheumatic Diseases, 2011,70(12):2238-2239.
[23] Parathithasan N, Lee W K, Pianta M, et al. Gouty arthropathy:review of clinico-pathologic and imaging features[J]. Journal of Medical Imaging and Radiation Oncology, 2016,60(1):9-20.
[24] 谢伟, 米晋, 朱晓敏.CT及磁共振成像诊断痛风性关节炎的准确性对比及影像特征分析[J]. 山西医药杂志, 2019,48(14):1676-1677. Xie W, Mi J, Zhu X M. Comparison of the accuracy and imaging characteristics of CT and MRI in the diagnosis of gouty arthritis[J].Shanxi Medical Journal, 2019,48(14):1676-1677.
[25] 刘磊, 武丽君.双源CT双能量技术在痛风诊断中的初步应用研究[J]. 影像研究与医学应用, 2018,2(15):144-145. Liu L, Wu L J. Preliminary application of dual-source CT dual energy technology in the diagnosis of gout[J].Journal of Imaging Research and Medical Application, 2018,2(15):144-145.