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Detection of Monosodium Urate Crystal of Hand and Wrist in Suspected Gouty Arthritis Patients on Dual-Energy CT and Relationship with Serum Urate Level

손과 손목의 통풍관절염에서 이중에너지 CT를 이용한 요산나트륨 결정 검출과 혈중 요산 농도와의 관계

  • Hana Choi (Department of Radiology, Hanyang University School of Medicine, Guri Hospital) ;
  • Jeongah Ryu (Department of Radiology, Hanyang University School of Medicine, Guri Hospital) ;
  • Seunghun Lee (Department of Radiology, Hanyang University School of Medicine, Seoul Hospital) ;
  • Yeo Ju Kim (Department of Radiology, Hanyang University School of Medicine, Seoul Hospital) ;
  • Soyoung Bang (Department of Rheumatology, Hanyang University School of Medicine, Guri Hospital)
  • 최하나 (한양대학교 의과대학 구리병원 영상의학과) ;
  • 류정아 (한양대학교 의과대학 구리병원 영상의학과) ;
  • 이승훈 (한양대학교 의과대학 서울병원 영상의학과) ;
  • 김여주 (한양대학교 의과대학 서울병원 영상의학과) ;
  • 방소영 (한양대학교 의과대학 구리병원 류마티스내과)
  • Received : 2021.12.26
  • Accepted : 2022.05.17
  • Published : 2023.01.01

Abstract

Purpose We retrospectively investigated the characteristics of patients with monosodium urate (MSU) deposits of the hand and wrist on dual-energy CT (DECT) compared to those without. We also attempted to determine the pattern of MSU distribution in DECT. Materials and Methods In total, 93 patients were included who had undergone DECT for evaluation of the hand or wrist pain under the clinical impression of gouty arthritis. The total volume of MSU deposits on DECT was calculated and the pattern of MSU distribution on DECT was analyzed. Also, the level of the serum urate at the time of DECT and the highest level of the serum urate of the patients were obtained from their records and the relationship between MSU and serum urate level was evaluated. Results The range of the volume of MSU deposits on DECT was 0.01-16.11 cm3 (average: 1.07 cm3). The average level of serum urate was significantly higher in the MSU positive group than that in the MSU negative group. MSU deposits were most frequently observed in the wrists followed by fingers and digitorum tendons. Conclusion On DECT, MSU deposits were most frequently detected in the wrist and related with high serum urate level.

목적 본 연구에서는 손과 손목의 이중에너지 CT (dual-energy CT)에서 요산나트륨(monosodium urate) 결정이 검출된 환자들은 그렇지 않은 환자들과 비교하여 어떤 특성을 가지는지 그리고 검출된 요산나트륨 결정은 어떤 양상으로 관찰되는지를 알아보고자 하였다. 대상과 방법 2015년 8월 1일부터 2020년 8월 31일까지 임상적으로 통풍이 의심되어 이중에너지 CT를 촬영한 93명의 환자를 대상으로 하였다. 이중에너지 CT에서 검출된 요산나트륨 결정의 부피 및 개수, 혈중 요산 농도와 그 최고치를 알아보았고, 요산나트륨 결정의 침착 양상을 분석하였다. 결과 이중에너지 CT에서 검출된 요산나트륨 결정의 부피는 0.01-16.11 cm3 (평균 1.07 cm3) 였다. 혈중 요산 농도의 평균값은 이중에너지 CT상 요산나트륨 결정이 발견된 환자군에서 유의미하게 높았다. 이중에너지 CT에서 요산나트륨 결정은 손목, 손가락, 수지건 순으로 많이 관찰되었다. 결론 이중에너지 CT에서 요산나트륨 결정은 손목 앞쪽에서 가장 흔하게 발견되었다.

Keywords

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