| 刘金玲,聂佩,魏耀宁,王锴,周锐志,陈颖,李长贵,徐文坚.双能CT联合MRI评估足踝部痛风骨侵蚀[J].中国医学影像技术,2026,42(5):754~758 |
| 双能CT联合MRI评估足踝部痛风骨侵蚀 |
| Dual energy CT combined with MRI for evaluating gouty bone erosion in foot and ankle |
| 投稿时间：2025-10-28 修订日期：2026-03-24 |
| DOI：10.13929/j.issn.1003-3289.2026.05.021 |
| 中文关键词: 痛风 骨侵蚀 体层摄影术,X线计算机 磁共振成像 |
| 英文关键词:gout bone erosions tomography, X-ray computed magnetic resonance imaging |
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| 摘要点击次数: 90 |
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| 中文摘要: |
| 目的 观察双能CT(DECT)联合MRI评估足踝部痛风骨侵蚀的价值。方法 前瞻性招募87例足踝部痛风患者,根据DECT显示有无骨侵蚀分为骨侵蚀组(n=59)与非骨侵蚀组(n=28)。基于DECT及MRI比较组间骨侵蚀位置及严重程度,单钠尿酸盐(MSU)晶体总体积、晶体沉积位置及评分,以及骨髓水肿、软组织肿胀及肌腱/韧带改变。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估各指标诊断痛风骨侵蚀的效能;以Spearman相关性分析观察骨侵蚀评分与影像学表现的相关性。结果 骨侵蚀发生率为67.82%(59/87),以第1跖骨头胫侧最易受累。组间MSU晶体总体积及沉积评分、骨髓水肿、软组织肿胀及肌腱/韧带改变差异均有统计学意义(P均＜0.05)。MSU晶体总体积和沉积评分诊断骨侵蚀的AUC分别为0.912和0.896。骨侵蚀评分与MSU晶体总体积(r=0.570,P＜0.001)及沉积评分(r=0.499,P＜0.001)均呈中度正相关,而与骨髓水肿评分无明显相关(r=0.211,P=0.108)。结论 DECT联合MRI可评估足踝部痛风骨侵蚀。 |
| 英文摘要: |
| Objective To observe the value of dual energy CT (DECT) combined with MRI for evaluating gouty bone erosion in foot and ankle. Methods Totally 87 patients with gout in foot and ankle were prospectively collected and divided into bone erosion group (n=59) and non-bone erosion group (n=28) according to the presence of bone erosion in DECT or not. DECT and MRI data were collected and compared between groups, including the location and severity of bone erosions, the total volume, deposition location and score of monosodium urate salt (MSU) crystals, bone marrow edema, soft tissue swelling and changes of tendon/ligament. Receiver operating characteristic (ROC) curves were plotted, the area under the curve (AUC) was calculated to evaluate the diagnostic efficacy of DECT and MRI indicators for diagnosing gouty bone erosion. Spearman correlation analysis was used to explore the relationships between bone erosion score and imaging manifestations. Results The incidence of bone erosion was 67.82% (59/87), and the lesions were most likely to involve the tibial side of the first metatarsal head. Significant differences of total volume and deposition score of MSU crystals, bone marrow edema, soft tissue swelling and tendon/ligament changes were found between groups (all P＜0.05). The AUC of MSU crystal total volume and deposition score for diagnosing bone erosion was 0.912 and 0.896, respectively. Moderate positive correlation was detected between the bone erosion score and total volume of MSU crystals (r=0.570, P＜0.001) and the deposition score (r=0.499, P＜0.001), but not between bone erosion score and bone marrow edema score (r=0.211, P=0.108). Conclusion DECT combined with MRI could be used to evaluate gouty bone erosion in foot and ankle. |
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