目的 应用双能量CT对足部痛风 石常见沉积部位进行分析，并对痛风发病 机制进行探讨研究。方法 回顾性分析56 例痛风患者的足部双能量CT扫描检查资 料。将根据痛风石沉积部位分为关节组、 韧带/肌腱组，并分别对其进行记录、分 析。结果 56例患者中双能量CT共发现51 例患者有痛风石沉积。关节组最常见受累 部位为第一跖趾关节(75%，73/198)，其 次是踝关节(33.9%，32/198)。韧带/肌腱 组中最常见受累部位依次是跟腱(39.3%， 37/99)、腓骨肌腱(16.1%，14/99)。结论 足部痛风石常见受累关节及韧带/肌腱分 别为第一跖趾关节及跟腱，足部痛风石的 沉积部位与特殊解剖部位、生物力学作用 等有关。

Objective To evaluate the distribution of tophus in foot using dual-energy CT (DECT)and to explore the pathogenesis of gout. Methods Fifty-six patients with gout had DECT scanning of both feet. The sites of tophus deposition were categorized into groups of joint, ligament/tendon and they were recorded and analyzed in order. Results The DECT scans showed tophus involving 51/56 (91.1%) patients. In the group of joint, gout affected the first metacarpophalangeal joint (75%, 73/198) mostly, followed bythe ankle joint (33.9%, 32/198).In the group of tendon/ligament, Achillestendon was the most commonly involved (39.3%, 37/99), followed bythe peroneal tendons (16.1%, 14/99). Conclusion In foot, tophus is commonly deposited at the first metacarpophalangeal joint and Achillestendon. The patterns of tophus deposition suggest that anatomical location, biomechanical strain or other local factors may contribute to the distribution of tophus.