To Explore The Diagnostic Value And Comparation Between Dual-source CT And MRI In Gout Arthritis

Objective: To investigate and compare the imaging performance between the dualsource CT(Dual Source CT,DSCT)and magnetic resonance imaging(MRI)in the gouty arthritis,reseach their diagnostic value and analysis how to select the optimal imaging technology in gout arthritis at different times.Materials and methods: 1.Study subjects: the imaging data of 150 patients who had joint swelling and pain admitted to the first affiliated hospital of wannan medical college were included in the study.108 patients who were clinically diagnosed as gout as the case group(including 48 during acute gout arthritis,60 during the intermittent period and the chronic arthritis),other 42 patients were not clinically diagnosed as gout as the control group 2?Equipments and methods:all 150 patients underwent dual-source CT examination,and the equipment was used for the second generation of the German Siemens ag(DSCT)dual-source CT imaging system(DSCT,somatom Definition flash,Siemens Healthcare,Forchheim,Germany,double-energy mode scanning);At the same time,there were 48 in 150 patients(including 42 patients in gout group)accepted the identical parts of the MRI,equipment adopts Siemens 1.5 T magnetic resonance(MRI)system(MAGNETOM Avanto1.5 T),using special body joints coil,and combine conventional line transverse,sagittal and coronal as multi-dimensional examination,scan used by sequence T1 WI,T2WI sequences,PDWI sequence(fat suppression)inhibition 3?Retrospective analysis: 1.108 gout patients were the case group,42 non-gout patients were the control group,analysis the detection of gout nodules between the two groups by double-source CT;2.analysis the the detection rate of gout nodules and bone destruction in gouty arthritis at different times by dual-source CT;3.in the 42 gouts group,compare and analysis the imaging performance such as tophus,bone changes,synovial joints variation,joint effusion and soft tissue swelling by dual-source CT and MRI.Results:1.Dual-source CT nodule imaging technology showed specific sensitivity(93.1%)and specificity(95.8%)to gout nodules.2.The detection rate of gout nodules in the acute stage of gouty arthritis was 87.5%(35/40),and bone damage was 30.0%(12/40);The detection rate of gout was 97.1%(66/68)and the detection rate of bone destruction was 69.0%(47/68).3.The dual-source computed tomography(CT)and magnetic resonance imaging(MRI)contrast: dual-source CT tophus detection rate 92.9%(39/42),bone damage detection rate 76.2%(32/42),joint effusion detection rate 57.1%(24/42),soft tissue swelling detection rate 64.3%(27/42);MRI for tophus detection rate was 71.4%(30/42),bone damage detection rate 69.0%(29/42),joint effusion detection rate 69.0%(29/42),soft tissue swelling detection rate 88.1%(37/42),cartilage damage detection rate 66.7%(28/42),synovial thickening detection rate 90.5%(38/42).Conclusion: 1.The dual-source CT has a high sensitivity and specificity for tophus in gouty arthritis,it can be a specific image tool for recognizing tophus,so it provides a reliable basis for clinical diagnosis.2.The detection rate of double-source CT in the intermittent period and the chronic arthritis was higher than that in the acute attack of gout.3.In the examination of gouty arthritis,the dual-source CT is superior to MRI in diagnosis of tophust and bone destruction.MRI has an advantage in show articular synovial and cartilage change;in the gouty arthritis at different times,selecting different imaging technology and even combining MRI and dual-source CT,can better evaluate the disease.