Department of Molecular Medicine and Pathology, Faculty of Medicine and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand.
Arthritis Res Ther. 2011;13(6):246. doi: 10.1186/ar3489. Epub 2011 Nov 4.
There are many exciting new applications for advanced imaging in gout. These modalities employ multiplanar imaging and allow computerized three-dimensional rendering of bone and joints (including tophi) and have the advantage of electronic data storage for later retrieval. High-resolution computed tomography has been particularly helpful in exploring the pathology of gout by investigating the relationship between bone erosions and tophi. Magnetic resonance imaging and ultrasonography can image the inflammatory nature of gouty arthropathy, revealing synovial and soft tissue inflammation, and can provide information about the composition and vascularity of tophi. Dual-energy computerized tomography is a new modality that is able to identify tophi by their chemical composition and reveal even small occult tophaceous deposits. All modalities are being investigated for their potential roles in diagnosis and could have important clinical applications in the patient for whom aspiration of monosodium urate crystals from the joint is not possible. Imaging can also provide outcome measures, such as change in tophus volume, for monitoring the response to urate-lowering therapy and this is an important application in the clinical trial setting.
在痛风的高级影像学应用方面有许多令人兴奋的新进展。这些技术采用多平面成像，并允许对骨骼和关节（包括痛风石）进行计算机化的三维渲染，具有电子数据存储的优势，便于以后检索。高分辨率计算机断层扫描（CT）通过研究骨侵蚀与痛风石之间的关系，特别有助于探索痛风的病理学。磁共振成像（MRI）和超声检查可以对痛风性关节炎的炎症性质进行成像，显示滑膜和软组织炎症，并提供关于痛风石成分和血管的信息。双能 CT 是一种新的技术，能够根据其化学成分识别痛风石，并显示甚至很小的隐匿性痛风石沉积。所有这些技术都在研究其在诊断中的潜在作用，对于那些无法从关节抽吸单钠尿酸盐晶体的患者，可能具有重要的临床应用价值。影像学还可以提供痛风石体积变化等疗效指标，用于监测降尿酸治疗的反应，这在临床试验中是一个重要的应用。
