Dual Energy CT Imaging In Suspected Clinical Application In Gouty Arthritis

Objective:Scanning for clinically suspected gouty arthritis patients with dual energy CT imaging and evaluating its diagnostic urate crystal deposition of the sensitivity and specificity of DECT and compared analysing between the images in gout patients with recognition processing and conventional 120kVp CT scanning.Clinical examination advantages and blood uric acid value were also included as analysis factors.To explore the clinical application value of dual source CT for suspected gout arthritis.Methods:89 cases of clinically suspected gouty arthritis patients as the research object,collecting the age and sex of the patients and the medical history,blood uric acid levels and clinical examination with clinical data of painless gout stone,and the final clinical diagnosis criteria standard of American College of Rheumatology 1977 ACR standard.The sensitivity and specificity of DECT diagnosis in calculation for the deposit of urate crystals,followed by the comparison between the image in gout patients with recognition processing and conventional 120kVp CT scanning group,analyzing the relationship with clinical examination and uric acid level,Evaluating clinical diagnostic value for asymptomatic hyperuricemia and initial onset of the patient.Results:1.The diagnosis of gout was confirmed in 71/89(79.78%)patients with clinically suspected gout arthritis.18/89(20.22%)(except for gout).69/89(77.53%)patients with visible green pseudo color showed positive.20/89(22.47%)patients with green pseudo color display showed negative results,the sensitivity of DECT diagnosis of gouty arthritis urate crystals for 67/71(94.37%),the specificity of 16/18(88.89%),the accuracy rate was 83/89(93.26%).2.The sensitivity of dual source CT weighted average fusion after conventional 120kVp imaging diagnosis of clinically suspected gout urate crystal deposition in 41/71(57.75%),the specificity of 10/18(55.56%),the accuracy rate was 51/89(57.30%),CT group and conventional dual image postprocessing was found in clinical suspected gouty arthritis sensitivity the specificity and accuracy of the differences were statistically significant.3.71 cases of gout patients in the examination of 32/71(45.07%)were detected in 91 patients with gout nodules,DECT scanning 67/71(94.37%)patients with a total of 275 urate deposition foci,DECT scan found that the number of urate deposition is 3.02 times of clinical examination of gout nodules,the difference was statistically significant(X2= 29.174,P<0.001).4.62/89(69.66%)patients with elevated serum uric acid level in patients with 27/89(30.34%)cases of blood uric acid in patients with normal DECT positive rate scanning deposition of urate crystals for completely random chi square test,the difference was not statistically significant(P =0.372).5.2/6(33.33%)asymptomatic hyperuricemia patients DECT scanning showed urate crystal green marker,11/13(84.62%)of patients with gouty arthritis showed deposition of urate crystals for the first episode,DECT findings and pathological results coincidence rate was 8/9(88.89%).Conclusion:The sensitivity and specificity in diagnosing urate deposition of gout with dual energy technique of dual source CT is higher than conventional CT imaging and clinical examination.Dual energy CT imaging can find more subclinical lesions and has great application value for the early diagnosis of clinically suspected gouty arthritis.