Combining non-contrast and dual-energy CT improves diagnosis of early gout.
Eur Radiol
; 29(3): 1267-1275, 2019 Mar.
Article
em En
| MEDLINE
| ID: mdl-30225600
ABSTRACT
OBJECTIVES:
To determine the incremental value of non-contrast CT (NCCT) on dual-energy CT (DECT) in symptomatic first metatarsophalangeal (MTP) joints in early gout.METHODS:
One hundred and fifteen painful joints were consecutively enrolled and gout was diagnosed based on the 2015 EULAR/ACR criteria and/or arthrocentesis. Two readers independently evaluated DECT alone and combined NCCT and DECT (NCCT+DECT) based on four semiquantitative scales. Sensitivities and specificities were compared using McNemar's test. AUC was compared.RESULTS:
Of the 115 joints, 72 were defined as an early gout group and 43 as a gout-negative group after exclusion. The sensitivity and specificity for the early gout group on DECT alone were as followed reader 1 - 52.8% and 100.0% and reader 2 - 51.4% and 100.0%. NCCT+DECT results were as follows reader 1 - 79.2% and 93.0% and reader 2 - 79.2% and 95.3%. AUC was significantly higher in NCCT+DECT compared to that in DECT alone for the early gout group (0.888 vs. 0.774 for reader 1, p = 0.0004; 0.896 vs. 0.816 for reader 2, p = 0.0142). The false-negative cases on DECT occurred more frequently with the first-onset gout, and tended to be affected by a longer duration of symptoms in the post-hoc analysis.CONCLUSION:
The combined analysis of NCCT and DECT improves diagnostic capabilities in symptomatic early gout involving the first MTP joint. KEY POINTS ⢠MSU crystal depositions in early gout may be seen on non-contrast CT, while still being undetectable by DECT. ⢠Combining non-contrast CT and DECT improves detection of early gout. ⢠False negatives of DECT are more common than previously reported in cases of first-onset gout.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Diagnóstico Precoce
/
Tomografia Computadorizada Multidetectores
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Gota
/
Articulação Metatarsofalângica
Tipo de estudo:
Diagnostic_studies
/
Screening_studies
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article