| Objective To explore the feasibility and application value of dual energy CT (DECT) semi-quantitative scoring system in the evaluation of urate crystals in patients with gout. Methods A total of 39 feet DECT scans of gout patients in the Affiliated Aoyang Hospital of Jiangsu University from August 2013 to August 2017 were retrospectively analyzed, and DECT was used for semi-quantitative scoring of urate crystallization. The urate crystal volume was measured using DECT quantification software. Intraclass correlation coefficient (ICC) was used to evaluate the semi-quantitative scoring reproducibility. Spearman correlation was used to analyze the correlation between the semi-quantitative score and the volume of urate, and to compare the time taken by the semi-quantitative score method and the quantitative software to measure the volume of urate. Results A total of 73 feet were scanned in 39 patients, and urate crystals were detected in 69 feet. DECT showed the highest score of urate crystal in tendons, followed by the first metatarsophalangeal joint, ankle/midfoot joint, and the lowest score of other joints in toes. The results of semi-quantitative analysis of urate crystal by two radiologists were consistent, ICC was 0.944. The average volume of urate crystal in 69 feet was (2.69±8.84) cm3. DECT urate score was closely related to volume (r=0.479,P<0.001). The time of using DECT scoring system to analyze the crystallization of urate was (68.18±15.16) seconds, (74.67±16.15) seconds, and the time of quantitative software analysis was (166.10±13.23) seconds. There was a significant difference between the three (F=527.029,P<0.001). Conclusion The semi-quantitative score of DECT urate crystals is feasible. Compared with the quantitative software to measure urate crystal volume, it is more time-efficient and convenient to use DECT scoring system, which is conducive to clinical application. |
