What is the diagnostic value of dual-energy computed tomography in patients with clinical diagnosis of gout?

Advances in Rheumatology

Jung Sun Lee¹  Wook Jang Seo¹ 

[1] Division of Rheumatology, Department of Internal Medicine, Seoul Veterans Hospital, 53 Jinhwangdo-ro 61-gil Gangdong-gu, 05368, Seoul, South Korea;

关键词: Monosodium urate;    Gout;    Dual-energy computed tomography;    Diagnostic imaging;   

DOI  :  10.1186/s42358-021-00198-0

来源: Springer

【 摘 要 】

ObjectivesTo investigate the frequency of monosodium urate (MSU) crystal deposits on dual-energy computed tomography (DECT) in patients with clinical diagnosis of gout and the factors associated MSU crystal positivity.MethodsThis study was conducted in patients with clinical diagnosis of gout who underwent DECT. Clinical features were compared between patients with positive and those with negative DECT results. A logistic regression analysis was performed to determine the factors associated with MSU crystal positivity on DECT.ResultsA total of 148 patients with clinical diagnosis of gout were included, and MSU crystal deposition on DECT was observed in 64 patients (43.3%). The patients with positive DECT results were more likely to have renal insufficiency, longer disease duration, and higher serum urate level than those with negative. In the multivariable analysis, first gout attack (odds ratio 0.462; 95% confidence interval 0.229–0.931, p = 0.031) was associated with a less likely MSU crystal deposit-positive DECT result. In the subgroup analysis of patients with first attack, serum urate level > 8 mg/dL was associated with DECT positivity.ConclusionOf the patients with clinical diagnosis of gout, those with renal insufficiency, longer disease duration, and high serum urate level were more likely to be positive of gout on DECT. First gout attack was associated with less likely to be positive for MSU crystal on DECT. Thus, performing DECT scan in the selected patients who had characteristics that highly probability of DECT positivity could increase positive predictive value.

【 授权许可】

CC BY