Chen J, Liao M, Zhang H, Zhu D
Department of Radiology, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, 430071, Wuhan City, Hubei province, China.
Z Rheumatol. 2017 Oct;76(8):723-729. doi: 10.1007/s00393-016-0250-8.
The aim of our study was to compare the overall accuracy of ultrasonography (US), with at least one sign positive (double contour, tophus, aggregates), and dual-energy CT in the diagnosis of gouty arthritis.
PubMed, Web of Science, EI, Elsevier, Wiley Online Library and Cochrane library were systematically searched for studies on the diagnostic performance of dual-energy CT (DECT) and ultrasound (US) from 2005 to February 2016. After study selection, data and quality assessment, the sensitivity (SEN), specificity (SPE), diagnostic odds rate (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and summary receiver operating contraction racteristic (SROC) curves were calculated.
Eleven publications met our inclusion criteria. Of these, six studies were included in the dual-energy CT group, six studies in the US group, and one study compared dual-energy CT and US. The pooled SEN, SPE, DOR, PLR, NLR and SROC of US with at least one sign positive, were 93%, 73%, 37.94, 3.39, 0.11 and 92%, respectively; and of DECT the values were 88%, 85%, 38.70, 5.12, 0.16, 93% and respectively.
Based on current evidence, both US and DECT can be used for diagnosis of gouty arthritis, but there are some differences between them regarding diagnostic sensitivity and specificity.
我们研究的目的是比较超声检查（US）（至少有一项阳性体征：双轮廓、痛风石、聚集物）和双能CT在痛风性关节炎诊断中的总体准确性。
系统检索PubMed、Web of Science、EI、Elsevier、Wiley Online Library和Cochrane图书馆，查找2005年至2016年2月期间关于双能CT（DECT）和超声（US）诊断性能的研究。经过研究筛选、数据和质量评估后，计算敏感性（SEN）、特异性（SPE）、诊断比值比（DOR）、阳性似然比（PLR）、阴性似然比（NLR）和汇总接收器操作特征（SROC）曲线。
11篇出版物符合我们的纳入标准。其中，双能CT组纳入6项研究，超声检查组纳入6项研究，1项研究对双能CT和超声进行了比较。至少有一项阳性体征的超声检查的汇总SEN、SPE、DOR、PLR、NLR和SROC分别为93%、73%、37.94、3.39、0.11和92%；双能CT的相应值分别为88%、85%、38.70、5.12、0.16和93%。
基于目前的证据，超声检查和双能CT均可用于痛风性关节炎的诊断，但二者在诊断敏感性和特异性方面存在一些差异。
