■这项研究调查了膝关节痛风性关节炎(KGA)的MRI特征,检查其与组织受累程度的关系,并评估风险因素是否可以预测KGA。
■诊断为KGA的患者接受了MRI检查,两名独立观察者回顾性分析了44例患者(49膝)的数据.根据关节镜检查期间观察到的组织受累,将这些患者分为轻度和重度组。总结MRI表现,和组内相关系数评估观察者间的再现性。单因素分析比较组间临床指标和MRI表现,而Cramer的V系数评估了相关性。多变量逻辑回归确定了组织受累程度的预测因子,和评价诊断性能的ROC曲线。
■在49个膝盖中,18例轻度,31例严重组织受累。MRI的主要特征包括韧带草图样改变,半月板尿酸盐沉积,不规则锯齿状软骨变化,关节积液内的低信号体征,滑膜增生,霍法脂肪垫滑膜炎,痛风Tophi,骨侵蚀,骨髓水肿.MRI特征的观察者间可靠性良好。前交叉韧带(ACL)素描样改变组间差异显著(P<0.05),霍法脂肪垫滑膜炎,还有痛风·托皮.ACL草图状更改(r=0.309),霍法脂肪垫滑膜炎(r=0.309),痛风石(r=0.408)与组织受累程度呈正相关(P<0.05)。ACL草图状更改(OR=9.019,95%CI:1.364-61.880),霍法脂肪垫滑膜炎(OR=6.472,95%CI:1.041-40.229),痛风石(OR=5.972,95%CI:1.218-29.276)是组织受累程度的独立预测因子(P<0.05)。ROC曲线下面积为0.862,灵敏度为67.70%,特异性94.40%,准确率为79.14%。
■这种对MRI特征的全面分析确定了韧带草图状变化,半月板尿酸盐沉积,关节积液内低信号征象为KGA的特征性MRI表现。不规则软骨改变对中青年患者的鉴别诊断有价值。ACL类似草图的更改,霍法脂肪垫滑膜炎,痛风痛风石与组织受累严重程度相关,对预测和评估KGA组织受累程度至关重要。
UNASSIGNED: This study investigates the MRI features of knee gouty arthritis (KGA), examines its relationship with the extent of tissue involvement, and assesses whether risk factors can predict KGA.
UNASSIGNED: Patients diagnosed with KGA underwent MRI examinations, and two independent observers retrospectively analyzed data from 44 patients (49 knees). These patients were divided into mild and severe groups based on tissue involvement observed during arthroscopy. MRI features were summarized, and the intraclass correlation coefficient evaluated interobserver reproducibility. Single-factor analysis compared clinical indicators and MRI features between groups, while Cramer\'s V coefficient assessed correlations. Multivariate logistic regression identified predictors of tissue involvement extent, and a ROC curve evaluated diagnostic performance.
UNASSIGNED: Among 49 knees, 18 had mild and 31 had severe tissue involvement. Key MRI features included ligament sketch-like changes, meniscal urate deposition, irregularly serrated cartilage changes, low-signal signs within joint effusion, synovial proliferation, Hoffa\'s fat pad synovitis, gouty tophi, bone erosion, and bone marrow edema. The interobserver reliability of the MRI features was good. Significant differences (P < 0.05) were observed between the groups for anterior cruciate ligament (ACL) sketch-like changes, Hoffa\'s fat pad synovitis, and gouty tophi. ACL sketch-like changes (r = 0.309), Hoffa\'s fat pad synovitis (r = 0.309), and gouty tophi (r = 0.408) were positively correlated with the extent of tissue involvement (P < 0.05). ACL sketch-like changes (OR = 9.019, 95 % CI: 1.364-61.880), Hoffa\'s fat pad synovitis (OR = 6.472, 95 % CI: 1.041-40.229), and gouty tophi (OR = 5.972, 95 % CI: 1.218-29.276) were identified as independent predictors of tissue involvement extent (P < 0.05). The area under the ROC curve was 0.862, with a sensitivity of 67.70 %, specificity of 94.40 %, and accuracy of 79.14 %.
UNASSIGNED: This comprehensive analysis of MRI features identifies ligament sketch-like changes, meniscal urate deposition, and low-signal signs within joint effusion as characteristic MRI manifestations of KGA. Irregular cartilage changes are valuable for differential diagnosis in young and middle-aged patients. ACL sketch-like changes, Hoffa\'s fat pad synovitis, and gouty tophi correlate with tissue involvement severity and are critical in predicting and assessing the extent of tissue involvement in KGA.