目的 比较X线和双能源CT对痛 风性关节炎的诊断价值。方法 回顾性 分析96例痛风性关节炎患者共186个患 病关节的X线和DECT影像表现，采用卡方 检验对比分析2种检查方法的检出率及 对不同病变的显示率。结果 X线和DECT 检查的检出率分别为52.69%(98/186)和 86.56%(160/186)，DECT高于X线，两 者比较差异有统计学意义(χ2 =33.56， P<0.005）。X线未见显示关节积液和 尿酸盐结晶，X线显示痛风结节、软 组织肿胀和骨质破坏关节个数少于 DECT(χ2 =45.06，P<0.005；χ2 =72.44， P<0.005；χ2 =11.27，P<0.005)，差异具 有统计学意义。结论 DECT较X线对痛风性 关节炎有更好的诊断价值，DECT对尿酸盐 结晶具有较高的特异性。

Obiective Compare the diagnosis value of X-ray and DECT imaging in gouty arthritis. Methods A retrospective study was performed in 186 symptomic joint of 96 patients with gouty arthritis. The images of X-ray and DECT were collected. The chisquare test was used to compare the diagnostic ability of X-ray and DECT. Results The diagnostic positive rate of X-ray and DECT were respectively 52.69%(98/186) and 86.56(160/186). DECT was superior to X-ray (χ2 =45.65,P<0.005). And X-ray did not show joint effusion and urate crystals. X-ray was inferior to DECT in finding gout node, soft tissue swelling and bone destruction(χ2 =45.06, P<0.005,χ2 =72.44, P<0.005, χ2 = 11.27, P<0.005). And There was significant difference. Conclusion The diagnosis of DECT is superior X-ray in GA, and DECT is characterized by specificity of urate crystals.