Diagnostic efficiency of high frequency ultrasound for gouty arthritis and detection rate comparison with other imaging methods

doi:10.3877/cma.j.issn.1672-6448.2016.04.003

Abstract

Abstract:

Objective

To evaluate the diagnostic efficiency of high frequency ultrasound (HFUS) for gouty arthritis (GA), and compare diagnostic coincidence rate with other imaging methods.

Methods

Retrospectively analysis imaging data of 285 cases clinically diagnosed as GA, of which 100 patients received HFUS examination. Select 40 patients with other arthritis as control group to conduct a diagnostic test, calculate the area under the receiver operating characteristic (ROC) curve (AUC) and evaluate diagnostic efficiency of HFUS. Analysis the results of X-ray, CT, MRI and Dual-energy CT (DECT) of 285 GA patients, and compare the diagnostic coincidence rate with HFUS.

Results

The sensitivity, specificity, positive predictive value, negative predictive value of HFUS were 89.0% (89/100), 95.0% (38/40), 97.8% (89/91) and 77.6% (38/49). The AUC was 0.877. In 285 GA patients, cases received X-ray, CT, DECT and MRI were 214 cases, 112 cases, 54 cases and 64 cases, respectively, and the diagnostic coincidence rate was 40.7% (87/214), 56.3% (63/112), 92.6% (50/54) and 62.5% (40/64), with the diagnostic coincidence rate of HFUS was 89.0% (89/100). The coincidence rate of HFUS was higher than those of X-ray, CT and MRI and the difference was statistically significant (χ²=64.665, 27.924 and 16.325, all P<0.05). While there was no statistically significant difference between HFUS and DECT (χ²=0.515, P>0.05).

Conclusions

HFUS has high efficiency in the diagnosis of GA. The diagnostic coincidence rate was significantly higher than those of X-ray, CT and MRI and was consistent with that of DECT. HFUS is preferred in diagnosing GA.

Key words: Gout, Arthritis, Ultrasonography

Xiaolan Tang, Yuanjiao Tang, Xi Xiang, Li Qiu. Diagnostic efficiency of high frequency ultrasound for gouty arthritis and detection rate comparison with other imaging methods[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(04): 249-253.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.04.003

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I04/249

Figures/Tables 6

References 22

[1]	de Avila Fernandes E, Sandim GB, Mitraud SA, et al. Sonographic description and classification of tendinous involvement in relation to tophi in chronic tophaceous gout [J]. Insights Imaging, 2010, 1(3): 143-148.
[2]	Dalbeth N, Fransen J, Jansen TL, et al. New classification criteria for gout: a framework for progress [J]. Rheumatology (Oxford), 2013, 52(10): 1748-1753.
[3]	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.
[4]	Dalbeth N, McQueen FM. Use of imaging to evaluate gout and other crystal deposition disorders [J]. Curr Opin Rheumatol, 2009, 21(2): 124-131.
[5]	McQueen FM, Doyle A, Dalbeth N. Imaging in gout--what can we learn from MRI, CT, DECT and US [J]. Arthritis Res Ther, 2011, 13(6): 246.
[6]	Wright SA, Filippucci E, McVeigh C, et al. High-resolution ultrasonography of the first metatarsal phalangeal joint in gout: a controlled study [J]. Ann Rheum Dis, 2007, 66(7): 859-64.
[7]	Wallace SL, Robinson H, Masi AT, et al. Preliminary criteria for the classification of the acute arthritis of primary gout [J]. Arthritis Rheum, 1977, 20(3): 895-900.
[8]	Chowalloor PV, Siew TK, Keen HI. Imaging in gout: A review of the recent developments [J]. Ther Adv Musculoskelet Dis, 2014, 6(4): 1311-43.
[9]	方静, 朱家安. 超声检查在类风湿性关节炎患者腕、手指关节中的应用进展[J/CD]. 中华临床医师杂志:电子版, 2011, 5(6): 1661-1663.
[10]	胡小涛, 陈苏宁. 高频彩色多普勒超声在类风湿性关节炎膝关节病变诊断中的应用价值[J/CD]. 中华医学超声杂志:电子版, 2012, 9(4): 67-68.
[11]	王丽萍, 刘艳芳, 李应强, 等. 类风湿性关节炎手部小关节病变的声像图表现[J/CD]. 中华医学超声杂志:电子版, 2010, 7(3): 450-455.
[12]	李长勤, 付建斌, 谢元忠, 等. 二羟焦磷酸钙晶体沉积症的影像学诊断 [J]. 中国矫形外科杂志, 2006, 14(18): 1404-1406.
[13]	Dalbeth N, Clark B, Gregory K, et al. Computed tomography measurement of tophus volume: comparison with physical measurement [J]. Arthritis Rheum, 2007, 57(3): 461-5.
[14]	冷钱英, 唐远姣, 张凌燕, 等. 不同超声表现在慢性痛风性关节炎诊断中的价值[J]. 四川大学学报(医学版), 2014, 45(3): 424-427, 446.
[15]	Dalbeth N, Doyle A, McQueen FM. Imaging in gout: insights into the pathological features of disease [J]. Curr Opin Rheumatol, 2012, 24(2): 132-138.
[16]	Gerster JC, Landry M, Dufresne L, et al. Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography [J]. Ann Rheum Dis, 2002 , 61(1): 52-54.
[17]	Szkudlarek M, Klarlund M, Narvestad E, et al. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination [J]. Arthritis Res Ther, 2006, 8(2): R52.
[18]	Nicolaou S, Yong-Hing CJ, Galea-Soler S, et al. Dual-energy CT as a potential new diagnostic tool in the management of gout in the acute setting [J]. AJR Am J Roentgenol, 2010, 194(4): 1072-1078.
[19]	Ostergaard M, Wiell C. Ultrasonography in rheumatoid arthritis: a very promising method still needing more validation [J]. Curr Opin Rheumatol, 2004, 16(3): 223-230.
[20]	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.
[21]	胡麦果, 李拾林, 吕国荣, 等. 高频超声与DECT对痛风性关节炎诊断价值的比较 [J]. 中国医学影像技术, 2014, 30(6): 909-912.
[22]	郭瑞君. 肌肉骨骼超声进入崭新时代[J/CD]. 中华医学超声杂志:电子版, 2015, 12(1): 3-5.

组别	例数	"双轨征"	"暴雪征"	关节、肌腱、腱鞘或软组织强回声	关节积液	骨侵蚀	滑膜炎
GA组	100	83（83）	43（43）	69（69）	88（88）	45（45）	49（49）
对照组	40	0（0）	0（0）	2（5）	35（88）	22（55）	21（53）
χ²值	?	81.54	24.83	46.82	0.01	1.15	0.14
P值	?	<0.05	<0.05	<0.05	>0.05	>0.05	>0.05

组别	例数	"双轨征"	"暴雪征"	关节、肌腱、腱鞘或软组织强回声	关节积液	骨侵蚀	滑膜炎
GA组	100	83（83）	43（43）	69（69）	88（88）	45（45）	49（49）
对照组	40	0（0）	0（0）	2（5）	35（88）	22（55）	21（53）
χ²值	?	81.54	24.83	46.82	0.01	1.15	0.14
P值	?	<0.05	<0.05	<0.05	>0.05	>0.05	>0.05

Please choose a citation manager

Content to export