痛风性关节炎的影像学诊断价值
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摘要
随着经济的发展和生活方式的改变,痛风的发病率在全球范围内呈逐年升高趋势。越来越多的痛风性关节炎(GA)患者受到疾病的困扰,疾病的早诊早治就显得尤为重要。目前痛风的诊断除了根据临床表现进行判断以外,影像学手段也发挥着越来越大的作用。目前用于痛风诊断的影像学检查有普通X线平片、CT、双源CT(DECT)、MRI、US等。然而,痛风的不同临床时期及不同的发病部位又给影像学诊断带来挑战。在痛风的诊断中,每种影像方法都各有优缺点,本文将阐述以上各成像方式在痛风诊断中发挥的作用。
With the development of economy and the change of life style, the incidence of gout is increasing year by year. More and more people with gouty arthritis are suffering from the disease, so early diagnosis and early treatment of the diseases is particularly important. At present, in addition to judging gout according to its clinical manifestations, imaging methods also play a more and more important role in the diagnosis of gout. The current imaging examinations for gout diagnosis include plain X-ray, Computed Tomography, Magnetic Resonance Imaging, Ultrasound, and Dual-energy Computed Tomography.However, different clinical stages and different sites of gout pose a challenge to imaging diagnosis. In the diagnosis of gout, each imaging method has its own advantages and disadvantages. This article will describe the role of the above imaging methods in the diagnosis of gout.
With the development of economy and the change of life style, the incidence of gout is increasing year by year. More and more people with gouty arthritis are suffering from the disease, so early diagnosis and early treatment of the diseases is particularly important. At present, in addition to judging gout according to its clinical manifestations, imaging methods also play a more and more important role in the diagnosis of gout. The current imaging examinations for gout diagnosis include plain X-ray, Computed Tomography, Magnetic Resonance Imaging, Ultrasound, and Dual-energy Computed Tomography.However, different clinical stages and different sites of gout pose a challenge to imaging diagnosis. In the diagnosis of gout, each imaging method has its own advantages and disadvantages. This article will describe the role of the above imaging methods in the diagnosis of gout.
引文
[1] Desai MA, Peterson JJ, Garner HW, Kransdorf MJ, et al. Clinical utility of dual-energy CT for evaluation of tophaceous gout [J]. Radiographics, 2011, 31(5): 1365-1375.
[2] Nishanthinie Parathithasan, Wai-Kit Lee, Marcus Pianta, et al. Gouty arthropathy: review of clinico-pathologic and imaging features [J]. J Med Imaging Radiat Oncol, 2016, 60(1): 9-20.
[3] Dalbeth N, Doyle AJ. Imaging of gout-An overview [J]. Best Pract Res Clin Rheumatol, 2012, 26(6): 823-838.
[4] McQueen FM, Doyle A, Dalbeth N. Imaging in gout-what we can learn from MRI, CT, DECT and US [J]. Arthritis Res Ther, 2011, 13(6): 246.
[5] Halberd N, Doyle A, Boyer L, et al. Development of a computed tomography method of scoring bone erosion in patients with gout: validation and clinical implications [J]. Rheumatology, 2011, 50(2): 410-416.
[6] Dalbeth N, Clark B, Gregory K, et al. Computed tomography measurement of tophus volume: comparison with physical measurement [J]. Arthritis Care Res (Hoboken), 2007, 57(3): 461-465.
[7] Neil Upadhyay, Asif Saifuddin. The radiographic and MRI features of gout referred as suspected soft tissue sarcoma: a review of the literature and findings from 27 cases [J]. Skeletal Radiol, 2015, 44(4): 467-476.
[8] 王旭,刘斌.痛风性关节炎的影像学诊断及进展[J].国际医学放射学杂志,2012,35(3):251-254.
[9] 于建秀,宋修恩,王锡明,等.痛风性关节炎的影像学诊断进展[J].医学影像学杂志,2017,27(5):926-928.
[10] Ogdie A, Taylor WJ, Weatherall M, et al. Imaging modalities for the classification of gout: systematic literature review and meta-analysis [J]. Ann Rheum Dis, 2015, 74(10): 1868-1874.
[11] Bongartz T, Glazebrook KN, Kavros SJ, et al. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study [J]. Ann Rheum Dis, 2015, 74(6): 1072-1077.
[12] Huppertz A, Hermann KA, Diekhoff T, et al. Systemic staging for ural crystal deposits with dual energy CT and ultrasound in patients with suspected gout [J]. Rheumatol Int, 2014, 34(6): 763-771.
[13] Melzer R, Pauli C, Treumann T, et al. Gout tophus detection-a comparison of dual energy CT (DECT) and histology [J]. Semin Arthritis Rheum, 2014, 43(5): 662-665.
[14] Dalbeth N, Schauer C, Macdonald P, et al. Methods of tophus assessment in clinical trials of chronic gout: a systematic literature review and pictorial reference guide [J]. Annals of the Rheumatic Diseases, 2011, 70(4): 597-604.
[15] Coursey CA, Nelson RC, Boll DT, et al. Dual-energy multid etector CT: how dose it work, what can it tell us, and when can we use it in abdominopelvic imaging [J]. RadioGraphics, 2010, 30(4): 1037-1055.
[16] Cimmino M, Zampogna G, Parodi M, et al. MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack [J]. Ann Rheum Dis, 2011, 70(12): 2238-2239.
[17] Carter JD, Kedar RP, Anderson SR, et al. An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs [J]. Rheumatology (Oxford), 2009, 48(11): 1442-1446.
[18] Chowalloor PV, Siew TK, Keen HI. Imaging in gout: a review of the recent developments [J]. Ther Adv Musculoskelet, 2014, 6(4): 131-143.
[19] Thiele R, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved [J]. Rheumatol Int, 2010, 30(4): 495-503.
[20] Daniela Fodor, Rodina Nestorova, Violeta Vlad, et al. The place of musculoskeletal ultrasonography in gout diagnosis [J]. Med Ultrason, 2014, 16( 4): 336-344.
[21] Lai K, Chiu Y. Role of ultrasonography in diagnosing gouty arthritis [J]. J Med Ultrasound, 2011, 19(1): 7-13.
[22] Neoqi T, Janson TL, Dalbeth N, et al. 2015 Gout classification criteria: an american college of rheumatology/european league against rheumatism collaborative initiative [J]. Ann Rheum Dis, 2015, 74(10): 1789-1798.
[23] Thiele RG, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved [J]. Rheumatology International, 2010, 30(4):495-503.
[24] Hong Chou, MBBS, FRCR, et al. Dual-energy CT in gout-A review of current concepts and applications [J]. J Med Radiat Sci, 2017, 64(1): 41-51.
[25] Catalin Codreanu, Luminita Enache. Is ultrasound changing the way we understand rheumatology including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout [J]. Med Ultrason, 2015, 17(1): 97-103.
[2] Nishanthinie Parathithasan, Wai-Kit Lee, Marcus Pianta, et al. Gouty arthropathy: review of clinico-pathologic and imaging features [J]. J Med Imaging Radiat Oncol, 2016, 60(1): 9-20.
[3] Dalbeth N, Doyle AJ. Imaging of gout-An overview [J]. Best Pract Res Clin Rheumatol, 2012, 26(6): 823-838.
[4] McQueen FM, Doyle A, Dalbeth N. Imaging in gout-what we can learn from MRI, CT, DECT and US [J]. Arthritis Res Ther, 2011, 13(6): 246.
[5] Halberd N, Doyle A, Boyer L, et al. Development of a computed tomography method of scoring bone erosion in patients with gout: validation and clinical implications [J]. Rheumatology, 2011, 50(2): 410-416.
[6] Dalbeth N, Clark B, Gregory K, et al. Computed tomography measurement of tophus volume: comparison with physical measurement [J]. Arthritis Care Res (Hoboken), 2007, 57(3): 461-465.
[7] Neil Upadhyay, Asif Saifuddin. The radiographic and MRI features of gout referred as suspected soft tissue sarcoma: a review of the literature and findings from 27 cases [J]. Skeletal Radiol, 2015, 44(4): 467-476.
[8] 王旭,刘斌.痛风性关节炎的影像学诊断及进展[J].国际医学放射学杂志,2012,35(3):251-254.
[9] 于建秀,宋修恩,王锡明,等.痛风性关节炎的影像学诊断进展[J].医学影像学杂志,2017,27(5):926-928.
[10] Ogdie A, Taylor WJ, Weatherall M, et al. Imaging modalities for the classification of gout: systematic literature review and meta-analysis [J]. Ann Rheum Dis, 2015, 74(10): 1868-1874.
[11] Bongartz T, Glazebrook KN, Kavros SJ, et al. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study [J]. Ann Rheum Dis, 2015, 74(6): 1072-1077.
[12] Huppertz A, Hermann KA, Diekhoff T, et al. Systemic staging for ural crystal deposits with dual energy CT and ultrasound in patients with suspected gout [J]. Rheumatol Int, 2014, 34(6): 763-771.
[13] Melzer R, Pauli C, Treumann T, et al. Gout tophus detection-a comparison of dual energy CT (DECT) and histology [J]. Semin Arthritis Rheum, 2014, 43(5): 662-665.
[14] Dalbeth N, Schauer C, Macdonald P, et al. Methods of tophus assessment in clinical trials of chronic gout: a systematic literature review and pictorial reference guide [J]. Annals of the Rheumatic Diseases, 2011, 70(4): 597-604.
[15] Coursey CA, Nelson RC, Boll DT, et al. Dual-energy multid etector CT: how dose it work, what can it tell us, and when can we use it in abdominopelvic imaging [J]. RadioGraphics, 2010, 30(4): 1037-1055.
[16] Cimmino M, Zampogna G, Parodi M, et al. MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack [J]. Ann Rheum Dis, 2011, 70(12): 2238-2239.
[17] Carter JD, Kedar RP, Anderson SR, et al. An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs [J]. Rheumatology (Oxford), 2009, 48(11): 1442-1446.
[18] Chowalloor PV, Siew TK, Keen HI. Imaging in gout: a review of the recent developments [J]. Ther Adv Musculoskelet, 2014, 6(4): 131-143.
[19] Thiele R, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved [J]. Rheumatol Int, 2010, 30(4): 495-503.
[20] Daniela Fodor, Rodina Nestorova, Violeta Vlad, et al. The place of musculoskeletal ultrasonography in gout diagnosis [J]. Med Ultrason, 2014, 16( 4): 336-344.
[21] Lai K, Chiu Y. Role of ultrasonography in diagnosing gouty arthritis [J]. J Med Ultrasound, 2011, 19(1): 7-13.
[22] Neoqi T, Janson TL, Dalbeth N, et al. 2015 Gout classification criteria: an american college of rheumatology/european league against rheumatism collaborative initiative [J]. Ann Rheum Dis, 2015, 74(10): 1789-1798.
[23] Thiele RG, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved [J]. Rheumatology International, 2010, 30(4):495-503.
[24] Hong Chou, MBBS, FRCR, et al. Dual-energy CT in gout-A review of current concepts and applications [J]. J Med Radiat Sci, 2017, 64(1): 41-51.
[25] Catalin Codreanu, Luminita Enache. Is ultrasound changing the way we understand rheumatology including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout [J]. Med Ultrason, 2015, 17(1): 97-103.