Sánchez-Pujol Javier, Valencia José, Ruiz-Nodar Juan-Miguel, Andrés Mariano
Intensive Medicine unit, Elche General University Hospital, Elche, Alicante, Spain.
Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.
PLoS One. 2025 Apr 3;20(4):e0320742. doi: 10.1371/journal.pone.0320742. eCollection 2025.
Some reports suggest monosodium urate (MSU) crystals may deposit in artery walls. This exploratory study evaluated the capacity of optical coherence tomography (OCT) to detect MSU crystals in vessel phantoms.
We used 3D-printed blood vessel phantoms made of photosensitive acrylic resins, with varying compliances. 0.1cc volume injections of centrifugated human synovial fluids containing MSU crystals, calcium pyrophosphate crystals or 0.9% saline were performed in four predefined locations in the phantoms. OCT was subsequently performed in a blinded manner by two cardiologists, experts in the technique. Two exploratory definitions for MSU crystal deposits were used, depicting a lesion with high attenuation (#1) or also with a linear morphology (#2). Diagnostic properties of both definitions were studied building 2x2 tables.
Definition #1 was found by OCT in 3/8 (37.5%) of MSU injections and in 3/16 (18.8%) of controls, what yielded a sensitivity of 37.5%, specificity of 81.3%, positive and predictive values of 50.0% and 72.2% respectively, and positive and negative likelihood ratios of 2 and 0.77. Definition #2 was only seen in 2 cases, both with MSU crystals (8.3%); this definition showed a sensitivity of 25.0%, specificity of 100%, positive and predictive values of 100.0% and 72.7%, a negative likelihood ratio of 0.8, while the positive ratio could not be calculated. Data seemed to be slightly better with Semirigid phantoms.
This preliminary, preclinical data suggest OCT could detect MSU crystals deposits in vessel walls.
一些报告表明尿酸单钠（MSU）晶体可能沉积在动脉壁中。本探索性研究评估了光学相干断层扫描（OCT）检测血管模型中MSU晶体的能力。
我们使用了由光敏丙烯酸树脂制成的具有不同顺应性的3D打印血管模型。在模型中的四个预定义位置注射0.1cc体积的含有MSU晶体、焦磷酸钙晶体或0.9%生理盐水的离心人滑液。随后由两位该技术专家心脏病专家以盲法进行OCT检查。使用了两种关于MSU晶体沉积的探索性定义，一种描述为具有高衰减的病变（定义#1），另一种还具有线性形态（定义#2）。通过构建2×2表格研究了这两种定义的诊断特性。
OCT在3/8（37.5%）的MSU注射中发现了定义#1，在3/16（18.8%）的对照中发现了该定义，其敏感性为37.5%，特异性为81.3%，阳性预测值和预测值分别为50.0%和72.2%，阳性和阴性似然比分别为2和0.77。定义#2仅在2例中出现，均为MSU晶体（8.3%）；该定义的敏感性为25.0%，特异性为100%，阳性预测值和预测值为100.0%和72.7%，阴性似然比为0.8，而阳性比无法计算。半刚性模型的数据似乎略好。
这些初步的临床前数据表明OCT可以检测血管壁中的MSU晶体沉积。
