| Purpose:To estimate the accuracy, sensitivity and specificity of dual-energy computed tomography (DECT) in detection of uric acid crystals in joints or periarticular structures in patients with arthralgia and patients suspected of having gout, with diagnostic criteria made by American Rheumatism Association (ARA) in1977as reference standard.Materials and Methods:With institutional review board approval, patient consent,239patients underwent dual-source, dual-energy (80and140kv) CT of a painful joint. A material decomposition algorithm was used to identify uric acid. Two blinded musculoskeletal radiologists evaluated the dual-energy CT images and classified the examination findings as positive or negative for the presence of uric acid crystals. Reference standard was the result of clinical diagnosis.Results:174of239patients (72.8%) obtained clear diagnoses.140/174(80.46%) were confirmed, with34/174(19.54%) concluded.In138/174(79.31%) patients uric acid crystals were identified on the treated images; in36/174(20.69%) patients, they were not.Sensitivity was130/140(92.86%); Specificity was26/34(76.47%). Conclusion:This assessment suggests that dual-energy CT is a sensitive, noninvasive, and reproducible method for identifying uric acid deposits in joints and periarticular soft tissues in patients suspected of having gout. |
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