目的 比较X线、CT和MRI三种影 像学检查方法在痛风性关节炎中的诊断 价值。方法 收集我院内科近一年(2017 年3月-2018年3月)经临床证实的116例痛 风性关节炎患者的影像学资料(X线、CT 和MRI)，比较三种影像检查对通风性关 节炎的检出率及影像学表现。结果 116 例患者共确诊病变关节241个，X线、CT 和MRI对痛风性关节炎的检出率分别为 53.11%(128/241)、73.86%(178/241)、 88.38%(213/241)；X线对病变关节中的痛 风性结节、关节面下囊变、软组织肿胀的 检出率显著少于CT、MRI(P<0.05)；CT对 病变关节中的痛风性关节、关节面下囊变 的检出率与MRI无显著差异(P>0.05)，CT 对病变关节中关节积液、软组织肿胀的检 出率显著少于MRI(P<0.05)。结论 X线、 CT和MRI三种影像学检查方法对痛风性关 节炎均具有较高的诊断价值，与X线及CT 检查相比，MRI在痛风性关节炎中的诊断 价值更高。

Objective To compare the diagnostic value of X-ray, CT and MRI for the diagnosis of gouty arthritis. Methods The imaging data (X-ray, CT and MRI) of 116 patients with gouty arthritis confirmed by clinical practice who were treated in internal medicine department of the hospital from March 2017 to March 2018 were collected. The detection rate and imaging findings were compared among the three imaging methods. Results A total of 241 affected joints were diagnosed in 116 patients. The detection rates of gouty arthritis by X-ray, CT and MRI were 53.11% (128/241), 73.86% (178/241) and 88.38% (213/241) respectively. The detection rates of gout nodules, articular sub-capsular changes and soft tissue swelling in the affected joints by X-ray were significantly less than those by CT and MRI (P<0.05). There was no significant difference in the detection rates of gouty joints and articular sub-capsular changes between CT and MRI (P>0.05), and the detection rates of joint effusion and soft tissue swelling by CT were significantly less than those by MRI (P<0.05). Conclusion Three imaging methods of X-ray, CT and MRI all have high clinical value for the diagnosis of gouty arthritis. MRI has higher diagnostic value in gouty arthritis compared with X-ray and CT.