Application value of dual-source CT urography with stellar photon detectors in the diagnosis of gout / 中国基层医药

ABSTRACT

Objective:To investigate the application value of dual-source CT urography with stellar photon detectors in the diagnosis of gout.Methods:Forty patients who were diagnosed with gout according to American College of Rheumatology Guideline for the Diagnosis of Gout and received treatment between April 2018 and May 2020 were included in the observation group. Forty patients who were concurrently diagnosed with osteoarthritis and received treatment in the same hospital were included in the control group. All patients underwent dual-source CT urography with stellar photon detectors and corresponding biochemical index detection. Blood levels of uric acid, urea nitrogen, creatinine, total cholesterol, and triglyceride were compared between the observation and control groups.Results:Blood levels of uric acid, creatinine, urea nitrogen, total cholesterol, and triglyceride in the observation group were (519.38 ± 97.91) μmol/L, (110.21 ± 18.29) μmol/L, (12.21 ± 3.29) mmol/L, (6.49 ± 1.22) mmol/L, (3.45 ± 1.89) mmol/L, respectively, which were significantly higher than those in the control group (310.45 ± 61.40) μmol/L, (86.22 ± 13.12) μmol/L, (6.82 ± 1.75) mmol/L, (4.75 ± 0.56) mmol/L, (1.98 ± 0.85) mmol/L, respectively ( t = 11.43, 6.741, 9.148, 8.198, 4.486, all P < 0.05). Dual-source CT urography with stellar photon detectors revealed that urate crystals (color coded as green) were detected in 3 and 36 patients from the control and observation groups, respectively, with the detection rate of 7.5% (3/40) and 90% (36/40), respectively. There was significant difference in urate crystal detection rate between the observation and control groups ( χ2 = 24.993, P < 0.05). In the control group, no obvious destruction of bone, tendon and ligament were observed, urate deposition, total volume of (1.023 ± 0.83) cm 3, was found in feet and knee joint of a small number of patients. In the observation group, there were 30 patients with uric acid crystals and bone destruction in the metatarsophalangeal joint ( n = 6), distal tibia ( n = 7), distal fibula ( n = 3), proximal talus ( n = 4), proximal calcaneus ( n = 6), and wrist joint ( n = 4). There were 20 patients with ligament or tendon damage, involving deltoid ligament ( n = 2), Achilles tendon ( n = 10), and extensor and flexor tendon ( n = 53). Total volume of uric acid crystals was (32.22 ± 5.83) cm 3. The volume of uric acid crystals deposited in the hand, elbow, feet and knee was (8.00 ± 4.92) cm 3, (5.32 ± 2.75) cm 3, (36.00 ± 15.54) cm 3, and (13.31 ± 9.14) cm 3, respectively. Conclusion:Dual-source CT urography with stellar photon detectors has a high sensitivity in the diagnosis of gout, can accurately locate and quantify uric acid crystals and is of high application value in the diagnosis of gout.