1. Graduate School, Hebei North University, Zhangjiakou Hebei 075000, China丨 2. Department of Radiology, Hebei General
Hospital, Shijiazhuang Hebei 050000, China丨 3. Siemens Healthineers Medical Systems LTD, Beijing 100102, China
Abstract：Objective To investigate the diagnostic value of non-contrast CT (NCCT) imaging combined with dual-energy CT (DECT)
with tin filtration in early gout patients with the first metatarsophalangeal (MTP1) joint involvement. Methods A retrospective study
of 93 patients (118 first metatarsophalangeal joints) with suspected early gout diagnosed by the 2015 ACR/EULAR gout classification
criteria was performed between February 1, 2017 and June 4, 2021. Two radiologists independently evaluated DECT for all enrolled
joints and then combined DECT and NCCT (DECT+NCCT) for gout diagnosis. Sensitivity, specificity, and accuracy were calculated
and compared using McNemar’s test, and receiver operating characteristic (ROC) analysis was performed for the two groups. True
positive and false negative cases in the early gout group were retrospectively analyzed. Results Of the 118 joints, 83 were in the
early gout group and 35 were in the non-gout group. The sensitivity, specificity and accuracy of DECT alone in diagnosing early
gout were 62.7%, 100% and 73.7% for reader 1 and 60.2%, 100% and 72.0% for reader 2. The sensitivity, specificity and accuracy
of DECT+NCCT were 77.1%, 97.1% and 83.0% for reader 1 and 73.5%, 97.1% and 80.5% for reader 2, respectively. The area
under the ROC curve (AUC) of DECT+NCCT was slightly higher than that of DECT (reader 1, 0.863 vs. 0.815丨 reader 2, 0.847 vs.
0.785). In the early gout group, the difference of serum uric acid concentration between true positive and false negative cases of the
two diagnostic methods was statistically significant. Conclusion DECT combined with NCCT images can improve the diagnostic
performance of patients with early gout involving the first metatarsophalangeal joint.
邵秋1,2，张琦2，张萌2，窦亚娜3，暴云锋2，陈英敏2. 双源能谱纯化双能CT结合平扫图像对早期痛风诊断性能研究[J]. 中国医疗设备, 2021, 36(10): 90-95.
SHAO Qiu1,2，ZHANG Qi2，ZHANG Meng2，DOU Yana3，BAO Yunfeng2，CHEN Yingmin2. Diagnostic Performance of Combining Dual Energy CT with Tin Filtration and
Non-Contrast CT Image for Early Gout. China Medical Devices, 2021, 36(10): 90-95.
