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Ann Rheum Dis:超低剂量CT可以检测疑似类风湿性关节炎患者的滑膜炎

2018-10-01 xiangting MedSci原创

手部对比增强ULD-CT可以描述手部的软组织炎症,并可通过非常低的辐射暴露完成(<0.01mSv)。

这项研究旨在证明对比增强超低剂量CT(ULD-CT)用于描述手部关节炎患者炎性软组织改变(滑膜炎、腱鞘炎和腱周炎)的可行性,并衡量其诊断准确性。

在这项获得机构审查委员会批准的研究中,36名疑诊类风湿性关节炎、年龄大于50岁的患者接受了体重调整的静脉造影剂给药ULD-CT(估计的放射线照射<0.01 mSv)和手部MRI检查。由三名阅片者使用改良的类风湿性关节炎MRI评分(RAMRIS),评估ULD-CT减影和MR图像的滑膜炎、腱鞘炎和腱周炎。询问患者希望将来采用哪种方式进行检查。使用MRI作为参考标准计算ULD-CT检测炎性变化的敏感性和特异性。使用Pearson相关的r值将总得分进行关联。

36名患者均在MRI上发现滑膜炎。ULD-CT在患者水平的敏感性为69%,关节水平为65%,特异性为87%。炎症更严重患者的敏感性更高(MRI RAMRIS> 1的敏感性为80%)。ULD-CT的改良RAMRIS总分和MRI之间几乎完全相关(Pearson's r=0.94)。关于未来检查的偏好,85%的患者更倾向于ULD-CT,而不是MRI。ULD-CT检测到的鉴别诊断多于MRI(8 vs 2/12)。

手部对比增强ULD-CT可以描述手部的软组织炎症,并可通过非常低的辐射暴露完成(<0.01mSv)。尽管在检测轻度病变时的敏感性不如MRI,ULD-CT可能会发展成为一种快速舒适的MRI替代检查。

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    2018-10-03 lmm397
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    2018-10-03 pcw106
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    2018-10-02 wxl882001

    学习一下

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