Advanced imaging in gout (Thai)
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Abstract
โรคเกาต์ (gout) เป็นโรคข้ออักเสบที่เกิดจากการสะสมผลึกเกลือโมโนโซเดียมยูเรต (monosodium urate) ในน้ำไขข้อและเนื้อเยื่อจากการมีระดับกรดยูริกในซีรัมสูง (hyperuricemia) เป็นระยะเวลานาน การ ตรวจวินิจฉัยโรคเกาต์ทำได้โดยการตรวจพบผลึกเกลือโมโนโซเดียมยูเรตในน้ำไขข้อของผู้ป่วยที่มีข้ออักเสบ หรือพบก้อนโทฟัส (tophus)1, 2 แต่ในบางกรณีเช่น ข้อขนาดเล็ก ตำแหน่งข้อลึก หรือไม่สามารถเจาะน้ำไขข้อมาตรวจได้ ส่งผลให้ไม่ได้รับการวินิจฉัยอย่างเฉพาะเจาะจงหรือเกิดความล่าช้า จึงมีการพัฒนาภาพถ่ายรังสีเพื่อใช้สำหรับช่วยการวินิจฉัย ในปัจจุบันเทคนิคภาพถ่ายรังสีในการวินิจฉัยโรคเกาต์ มีหลายเทคนิค ได้แก่ ภาพรังสีพื้นฐาน (plain radiography), อัลตราซาวนด์ (ultrasonography), เอกซเรย์คอมพิวเตอร์ความเร็วสูงสองพลังงาน (Dual energy computed tomography; DECT), เครื่องสร้างภาพด้วยสนามแม่เหล็กไฟฟ้า (Magnetic Resonance Imaging; MRI), เวชศาสตร์นิวเคลียร์ (Nuclear Medicine) เทคนิคแต่ละชนิดช่วยในการวินิจฉัยและมีข้อจำกัดที่แตกต่างกัน ดังกล่าวต่อไป
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