Value Analysis Of Dual-energy Spectroscopic CT Diagnosis Of Gout Urate Deposition

Objective: Using dual-energy spectroscopy CT to identify gout,to perform the spectrum multi-parameter analysis of the mono-sodium urate(MSU)deposition in the joints of knees,ankles and wrists of gout patients.To observe the features of the urate deposition and understand the regularity of MSU deposition of gout patients in the joints of knees,ankles and wrists,and to discuss the relations between and among the characteristics of uric acid deposition of gouty arthritis with their clinical symptoms and serum uric acid values.Methods: 107 gout patients measuring up the screening criteria were selected,including 90 male patients and 17 female patients.All the patient cases are collected from the Department of Rheumatology and Endocrinology of the First Affiliated Hospital of Anhui Medical University from November 2015 to February 2018,with complete files.All the patients have undergone DECT examination after signing the Informed Consent Form.All the patients have participated in the experiments voluntarily,with detailed records of each patient's name,age,gender,duration,clinical features,and quantitative scores for clinical symptoms.All the subjects were tested on GSI scans and serum uric acid values to observe the regularity of MSU depositional distribution,such as the part of deposition,and to count the parts number and collate the data and perform statistical process of the data.Results 1.Among 107 gout patients,57 patients suffered from knee gout,having 283 uric acid depositional distribution parts,with the largest number of depositions of medial and lateral collateral ligaments,anterior and posterior cruciate ligaments,and tendons(more quadriceps tendon tendons),followed by the uric acid depositions in the tarsal ligaent,supraorbital bursa,meniscus attachment,articular cartilage and the joint cavity,which were relatively low.A total of 213 urate crystal deposition parts were detected in 63 patients suffering from foot gout arthritis.The number of metatarsophalangeal joints,sacroiliac joints,soft tissues and tendons(with more Achilles tendons)were higher,followed by the lower rate of urate deposition in the lower tibia,calcaneus,talus,and joint cavity;24 cases of gout.A total of 283 parts of urate crystal deposition were detected in 24 patients suffering from hand gout,among which,the proportion of metacarpophalangeal joints,interphalangeal joints,tendons,wrist joints,soft tissues,and ligaments was higher,followed by the distal ulnar radius,intra-articular cavity,and dorsal tendons with relatively low MSU deposition.2.The uric acid deposition counts were divided into three groups: mild,moderate,and severe.The uric acid crystallographic parts counts were 2.63±1.41,7.43±1.49,16.73±5.30,respectively.The corresponding clinical symptom scores were 5.23±2.10,8.23±2.51,11.73 ±2.58,which were compared by one-way variance analysis,showed that the difference was statistically significant and presented a linear positive correlation.According to the level of serum uric acid,it was divided into hyperuricemia group and normal group.The serum uric acid values were 556.29±98.74,342.61±57.44,and the corresponding uric acid deposition parts counts were 5.97±4.46 and 6.51±6.56,respectively.There were no statistically significant differences between the two independent sample T tests.Conclusion 1.Urinate is easily deposited around the joints in tendons and ligaments under higher forces.It is speculated that the urate deposition is related to the pressure.2.The level of serum uric acid had no correlation with the urate deposition part count.As the uric acid deposition part count was positively correlated with clinical symptoms,the uric acid deposition parts,the more obvious clinical symptoms.