Zeitschrift für Rheumatologie

, Volume 76, Issue 8, pp 723–729 | Cite as

Diagnostic accuracy of dual-energy CT and ultrasound in gouty arthritis

A systematic review
  • J. Chen
  • M. LiaoEmail author
  • H. Zhang
  • D. Zhu



The aim of our study was to compare the overall accuracy of ultrasonography (US), with at least one sign positive (double contour, tophus, aggregates), and dual-energy CT in the diagnosis of gouty arthritis.


PubMed, Web of Science, EI, Elsevier, Wiley Online Library and Cochrane library were systematically searched for studies on the diagnostic performance of dual-energy CT (DECT) and ultrasound (US) from 2005 to February 2016. After study selection, data and quality assessment, the sensitivity (SEN), specificity (SPE), diagnostic odds rate (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and summary receiver operating contraction racteristic (SROC) curves were calculated.


Eleven publications met our inclusion criteria. Of these, six studies were included in the dual-energy CT group, six studies in the US group, and one study compared dual-energy CT and US. The pooled SEN, SPE, DOR, PLR, NLR and SROC of US with at least one sign positive, were 93%, 73%, 37.94, 3.39, 0.11 and 92%, respectively; and of DECT the values were 88%, 85%, 38.70, 5.12, 0.16, 93% and respectively.


Based on current evidence, both US and DECT can be used for diagnosis of gouty arthritis, but there are some differences between them regarding diagnostic sensitivity and specificity.


Gouty arthritis Dual-energy CT Ultrasound At least one sign positive Monosodium urate crystal deposition 

Diagnostische Genauigkeit der Dual-Energy-CT und des Ultraschalls bei Gichtarthritis

Systematische Übersicht



Ziel der vorliegenden Studie war der Vergleich der Gesamtgenauigkeit der Ultraschalluntersuchung (US) bei Vorliegen mindestens eines positiven Kriteriums (Doppelkontur, Tophus, Aggregate) und der Dual-Energy-Computertomographie (DECT) für die Diagnosestellung der Gichtarthritis.


Systematisch wurden die Datenbanken PubMed, Web of Science, EI, Elsevier, Wiley Online Library und Cochrane Library von 2005 bis Februar 2016 nach Studien zur diagnostischen Leistungsfähigkeit der DECT und des US durchsucht. Nach Auswahl entsprechender Studien, Daten- und Qualitätserfassung wurden die Sensitivität (SEN), Spezifität (SPE), diagnostische Odds Rate (DOR) und die Summary-Receiver-Operating-Characteristic(SROC)-Kurve berechnet.


Elf Publikationen stimmten mit den Einschlusskriterien der Autoren überein. Davon gehörten 6 Studien in die DECT-Gruppe, 6 Studien in die US-Gruppe, und eine Studie verglich DECT mit US. Die gepoolte (95%-Konfidenzintervall, 95%-KI) Sensitivität, Spezifität, diagnostische Odds Rate, PLR, NLR und SROC für US mit mindestens einem positiven Kriterium lagen bei 0,93; 0,73; 37,94; 3,39; 0,11 bzw. 0,92; und für DECT betrugen die Werte 0,88; 0,85; 38,70; 5,12; 0,16 bzw. 0,93.


Nach derzeitiger Evidenzlage können sowohl US als auch DECT zur Diagnosestellung einer Gichtarthritis eingesetzt werden, es gibt jedoch Unterschiede zwischen ihnen in Bezug auf die diagnostische Sensitivität und Spezifität.


Gichtarthritis Dual-Energy-Computertomographie Ultraschall Mindestens ein positives Kriterium Mononatriumuratkristallablagerung 



We would like to thank Wuhan University for providing the platform for literature search and Zhongnan Hospital for administrative support.

Compliance with ethical guidelines

Conflict of interest

J. Chen, M. Liao, H. Zhang and D. Zhu declare that they have no competing interests.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. This article does not contain any studies with human or animal subjects performed by the any of the authors.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of RadiologyZhongnan Hospital of Wuhan UniversityWuhan CityChina

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