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1、双源CT对痛风性关节炎早期诊断的价值[摘要]目的探讨双源CT对痛风性关节炎早期诊断的价值。方法选取2015年1月〜2016年1月我院收治的临床疑似痛风患者227例,其中108例足踝部疼痛,63例手部疼痛,56例膝关节处疼痛,分别对这三组痛风患者进行双源CT扫描,以美国风湿病学会(ACR)的分类标准作为痛风诊断的“金标准”,通过对图片进行分析详细记录三组的扫描结果,对其所有数据及特异度和灵敏度进行统计学分析。结果108例双侧足部及踝关节疼痛患者中,确诊96例,双源CT诊断的准确度为95.37%,特异度75.00%,灵敏度97.92%;63例双侧手部及腕关节疼痛患者中,确诊痛风50例,双源CT诊断
2、的准确度为88.89%,特异度61.54%,灵敏度96.00%;在56例膝关节处疼痛的患者中,确诊46例,双源CT诊断的准确度为89.28%,特异度80.00%,灵敏度91.30%。结论双源CT作为现在临床上一种诊断痛风性关节炎的主要方法之一,具有无创性和可重复性,对提高痛风的诊断率有积极意义,且安全性更高,值得临床推广应用。[关键词]双源CT;痛风性关节炎;早期诊断;价值分类号]R445.3[文献标识码]A[文章编号]1674-4721(2016)06(a)-0119-03[Abstract]ObjectiveToexploreearlydiagnosticvalueofdual-sourc
3、eCTongoutyarthritis.MethodsFromJanuary2015toJanuary2016,227patientsdiagnosedassuspectedgoutwereadmittedintoourhospitalandselected.Amongthem,108caseswithfootandanklepain,63caseswithhandpain,and56caseswithkneejointpain.Allthesegoutpatientswereperformedwithdual-sourceCTscanning.Accordingtogoldstandardo
4、fgoutdiagnosisdraftedbyAmericanCollegeofRheumatology(ACR)classification,thescanningoutcomeswereanalyzedandrecordedindetailontheseimages.Thedata,specificity,andsensitivitywerestatisticallyanalyzed.ResultsAmongthese108patientswithbilateralfootandanklepain,96casesweredefinitelydiagnosedbydual-sourceCTi
5、nclinic,thediagnosticaccuracy,specificityandsensitivitywas95.37%,75.00%and97.92%respectively.Amongthese63patientswithbilateralhandandwristpain,50onesweredefinitelydiagnosed,thediagnosticaccuracy,specificityandsensitivityofdual-sourceCTwas88.89%,61.54%and96.00%respectively.Amongthese56patientswithkne
6、ejointpain,46casesweredefinitelydiagnosedinclinic,thediagnosticaccuracy,specificityandsensitivityofdual-sourceCTwas89.28%,80.00%and91.30%respectively.ConclusionDual-sourceCTasaprincipalmeanstodiagnosegoutyarthritisinmodernclinichasadvantagesofnon-invasionandrepeatabilityaswellasplaysapositivesignifi
7、canceonimprovingdiagnosticpossibilityofgout.Itisinhighersafetyandworthyofpromotionandapplicationinclinic.[Keywords]Dual-sourceCT;Goutyarthritis;Earlydiagnosis;Value随着越来越多人生活方式及饮食结构的不断变化,痛风已成为临床上的常见病[1