Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Department of Radiology, Musculoskeletal Imaging Research, University of Arizona Health Sciences, Tucson, AZ.
AJR Am J Roentgenol. 2019 Dec;213(6):1315-1323. doi: 10.2214/AJR.19.21404. Epub 2019 Sep 25.
The objective of our study was to compare ultrasound (US) tophus and monosodium urate (MSU) deposit detection and US tophus size in the metatarsophalangeal (MTP) 1 joint with dual-energy CT (DECT) using two DECT postprocessing protocols in patients presenting with podagra. Seventy-five consecutive patients with podagra (66 men and nine women; mean age, 65.6 years; age range, 33-88 years) and 75 control subjects with MTP 1 joint osteoarthritis (49 men and 26 women; mean age, 63.0 years; age range, 35-87 years) prospectively underwent US and DECT between 2016 and 2018 to assess the MTP 1 joint. Two Syngovia postprocessing DECT protocols with different minimum attenuation thresholds of 150 HU (DECT 150 protocol) versus 120 HU (DECT 120 protocol) and the same maximum attenuation threshold (500 HU) and constant kilovoltage setting of tubes A and B at 80 and 140 kVp were evaluated. Interobserver variability of the two DECT protocols was calculated and compared with that of US. The postprocessing DECT 150 protocol was positive for tophus detection in 55 of 75 patients (73.3%) with podagra, whereas the postprocessing DECT 120 protocol detected MSU deposits in all 75 patients (100%). Tophus size assessed using the DECT 120 protocol showed an improved correlation with tophus size detected on US ( < 0.01). Interobserver variability of DECT was improved when using the DECT 120 protocol ( < 0.01). The postprocessing DECT 120 protocol enables improved visualization of MSU deposits and provides more accurate information about tophus size that better correlates with tophus size on US compared with the standard postprocessing DECT 150 protocol.
我们的研究目的是比较超声 (US) 痛风石和单钠尿酸盐 (MSU) 沉积的检测以及双能 CT (DECT) 在跖趾关节 (MTP) 1 关节中的痛风石大小，使用两种 DECT 后处理协议，检查痛风患者。75 例连续的痛风患者（66 名男性和 9 名女性；平均年龄 65.6 岁；年龄范围 33-88 岁）和 75 例 MTP 1 关节骨关节炎对照受试者（49 名男性和 26 名女性；平均年龄 63.0 岁；年龄范围 35-87 岁）前瞻性地在 2016 年至 2018 年之间进行 US 和 DECT 检查，以评估 MTP 1 关节。两种 Syngovia DECT 后处理协议使用不同的最小衰减阈值（150 HU[DECT 150 协议]与 120 HU[DECT 120 协议]）和相同的最大衰减阈值（500 HU）以及恒定的管 A 和 B 的千伏设置（80 和 140 kVp）进行了评估。计算了两种 DECT 协议的观察者间变异性，并与 US 进行了比较。在后处理 DECT 150 协议中，55 例（73.3%）痛风患者检测到痛风石阳性，而在后处理 DECT 120 协议中，75 例患者均检测到 MSU 沉积。使用 DECT 120 协议评估的痛风石大小与 US 检测到的痛风石大小相关性更好（<0.01）。使用 DECT 120 协议时，DECT 的观察者间变异性得到改善（<0.01）。后处理 DECT 120 协议可改善 MSU 沉积的可视化，并提供更准确的痛风石大小信息，与标准后处理 DECT 150 协议相比，与 US 检测到的痛风石大小相关性更好。
