APPLICATION OF DUAL-ENERGY COMPUTED TOMOGRAPY IN DIAGNOSING GOUT AT BACH MAI HOSPHITAL

Hiệp Hòa Trần, Mạnh Cường Phạm, Minh Thông Phạm

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Abstract

Object: To describe the clinical characteristics, tests, dual energy computed tomography (DECT) imaging of gout patients at Bach Mai hospital and to present types of urate crystal deposition artifacts and their management. Subjects and Methods: A total of 36 patients underwent DECT imaging for the diagnosis and differential diagnosis of gout at Bach Mai Hospital from January 2020 to August 2024. Research design: Cross- sectional description. Results: Study on 36 patients (31 male and 5 female), with an average age of 52 (range 18-82). Patients had diverse clinical symptoms. Using ACR scoring combined with clinical and blood uric acid: 28 cases were in group 2, with the diagnosis dependent on DECT results (77.8 of cases). Using ACR scoring with clinical, blood uric acid, and DECT: 16 diseases were diagnosed as gout making DECT useful for diagnosing gout in 11/16 (~69% of gout patients) and ~39.3% among 28 suspected patients. Urate/gout crystal ratio: 15/16 patients. Average urate volume/gout: 3.91ml. Urate crystal deposition sites: 60% at the metatarsophalangeal joint. Artifact rate: 27,8%. Common artifacts include: thick skin, nail bed, motion, point, and beam -hardening artifacts. Underfined artifacts are rare and require coordination with other criteria. Conclusion: DECT plays an important role in the definitive diagnosis and differentiation of gout, especially in cases where clinical criteria and serum uric acid testing are not sufficient to confirm or rule out the disease. Urate crystal deposition artifacts are common, but can be recognized and corrected to avoid false positives, increasing the accuracy of diagnosis and treatment.

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References

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