A Study on the Diagnostic Value of Dual-Energy CT (DECT) Imaging in Patients With Gouty Arthritis.

OBJECTIVES

To explore the diagnostic value of dual-energy computed tomography (DECT) in patients with gouty arthritis.

METHODS

A total of 160 patients with gouty arthritis who were treated in our hospital from January 2023 to October 2023 were selected as the research subjects. The participants were randomly divided into two groups: an observation group and a control group. Each group had 80 cases. Observation group performed DECT examination and control group performed X-ray examination. The researchers recorded the general information of the participants in both groups and conducted single-factor analysis. They compared the detection of positive diseased joints between the two groups, as well as compared the distribution of positive diseased joints. In addition, the number of joint lesions was compared in the two groups.

RESULTS

There were not any statistically great differences between the two groups in gender, age, BMI, disease duration, blood uric acid, and erythrocyte sedimentation rate (p > 0.05). During the DECT examination, a total of 82 positive diseased joints were identified in the observation group. The observation group also had a positive rate of 85.42% (82/96) in the DECT examination. While the control group had a total of 55 positive diseased joints during the X-ray examination with a positive rate of 59.78% (55/92). The difference between the two groups of patients in the positive rate of two kinds of examination was statistically significant (χ = 15.616, p < 0.001). No statistical significance was found in the distribution of the number of positive diseased joints between two groups (χ = 1.986, p = 0.851). Both DECT and X-ray examinations of patients in the two groups revealed that the lesions were primarily located in the soft tissues or ligaments surrounding the distal small joints of the limbs, such as metatarsophalangeal joints, ankle joints, and proximal interphalangeal joints. Compared with the X-ray examination of the patients, the DECT examination of the patients showed a great increase in the number of bone destruction, gout nodules, and soft tissue swelling (χ = 7.712, 10.441, 5.389, p = 0.005, 0.001, 0.020). Moreover, the DECT examination of patients showed the presence of urate crystals and joint effusion, while the X-ray examination of patients in the control group did not show any.

CONCLUSIONS

Siemens dual-source 64-slice CT dual-energy imaging has better diagnostic value for gouty arthritis than X-ray and has higher specificity for detecting urate crystals and joint effusion. Therefore, Siemens dual-source 64-slice CT dual-energy imaging examination may serve as a promising new noninvasive technique for early diagnosis, clinical screening, and follow-up of gout in the future.