摘要
目的：比较X线、CT和MRI检查对痛风性关节炎的诊断价值。方法：回顾性分析56例痛风性关节炎患者共112个患病关节的X线、CT和MRI影像资料，采用卡方检验对比分析3种检查方法的检出率及对不同病变的显示率。结果：X线、CT、MRI检查的检出率分别为53%（59/112）、74%（83/112）、88%（99/112），MRI高于CT、X线（χ2=7.502，P=0.006；χ2=34.369，P<0.001）。X线显示痛风结节、关节面下囊变的关节个数少于MRI（χ2=24.605，P<0.001；χ2=31.112，P<0.001）和CT（χ2=18.576，P<0.001；χ2=13.069，P<0.001）。CT检查显示痛风结节和关节面下囊变的关节个数与MRI比较差异无统计学意义（χ2=0.466，P=0.495；χ2=3.211，P=0.073），但显示关节滑膜及韧带侵蚀、关节软骨侵蚀、关节积液和关节周围肌间隙水肿的关节个数均少于MRI（χ2=19.790，P<0.001；χ2=11.568，P<0.001；χ2=13.297，P<0.001；χ2=6.720，P=0.01）。结论：X线、CT和MRI对痛风性关节炎均有较好的诊断能力，其中MRI检查总的检出率较高、发现病变的能力较好，CT检查则对痛风结节具有较高的特异性，而X线适用于中晚期患者的复查对照。
Abstract
Objective: To compare the diagnosis value of X-ray, CT and MRI imaging in gouty arthritis. Methods: A retrospective study was performed in 112 symptomic joint of 56 patients with gouty arthritis. The images of X-ray, CT and MRI were collected. The Chi-square test was used to compare the diagnosis ability of X-ray, CT and MRI. Results: The diagnostic positive rate of X-ray, CT and MRI were 53%(59/112), 74%(83/112) and 88%(99/112) respectively. MRI was superior to X-ray and CT(χ2=7.502, P=0.006; χ2=34.369, P<0.001）. X-ray was inferior to CT(χ2=18.576, P<0.001; χ2=13.069, P<0.001) and MRI(χ2=24.605, P<0.001; χ2=31.112, P<0.001) in finding a tophus joint and cystic relevant section under the surface of the joints. There was no significant difference between CT and MRI in finding a tophus joint and cystic relevant section under the surface of the joints(χ2=0.466, P=0.495; χ2=3.211, P=0.073). However, MRI was superior to CT in finding synovial thickening and ligament erosion, cartilage erosion, joint effusion and muscle edema around the joint gap(χ2=19.790, P<0.001; χ2=11.568, P<0.001; χ2=13.297, P<0.001; χ2=6.720, P=0.01). Conclusion: X-ray, CT and MRI all could be used for the diagnosis of gouty arthritis. The diagnosis of MRI was superior to the others, but CT is characterized by specificity of tophus and X-ray could be employed in patients with comparison of severe lesion.
关键词
关节炎 /
痛风性 /
放射摄影术 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Arthritis /
gouty /
Radiography /
Tomography /
spiral computed /
Magnetic resonance imaging
漆 强;邹玉林;余 晖;刘 晓;李志娟.
痛风性关节炎的X线、CT和MRI诊断价值比较[J]. 中国临床医学影像杂志. 2015, 26(7): 523-527
QI Qiang;ZOU Yu-lin;YU Hui;LIU Xiao;LI Zhi-juan.
Comparison of X-ray, CT and MR imaging in gouty arthritis[J]. Journal of China Clinic Medical Imaging. 2015, 26(7): 523-527
中图分类号：
Ｒ684.3
R814.41
R814.42
Ｒ445.2
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