Diagnostic and Score Value of Ultrasound and Magnetic Resonance Imaging in Hemophilia Arthropathy
ISTH Academy. Ma F. Jul 10, 2019; 273745; OC 70.5 Topic: Hemophilia - Clinical
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OC 70.5

Diagnostic and Score Value of Ultrasound and Magnetic Resonance Imaging in Hemophilia Arthropathy

F. Ma1, Y. Li1, J. Sun2, Y. Zhang1, H. Liu1, S. Zhang1, L. Xiao3, W. Luo1, L. Zhang1, W. Wang1, S. Qiu2
1Nanfang Hospital, Southern Medical University, Department of Medicine Ultrasonics, Guangzhou, China, 2Nanfang Hospital, Southern Medical University, Department of Hematology, Guangzhou, China, 3The Second People's Hospital of Shenzhen, Department of Ultrasound, Shenzhen, China

Main Topic: Hemophilia and Bleeding (including Transfusion)
Category: Hemophilia - Clinical

Background: To find a convenient evaluation tool for hemophilia arthritis.
Aims: Referring to MRI on the diagnosis of hemophiliac arthropathy, to explore the diagnostic value of ultrasound on hemophiliac arthropathy.
Methods: The ultrasound and MRI examinations were performed on 42 joints of 42 hemophilia patients (14 knees, 14 ankles and 14 elbows). The consistency of ultrasound and magnetic resonance imaging in the detection and score of joint diseases was compared. Finally, inter-and intra-observer agreements of ultrasound scoring system were tested.
Results: The consistency of ultrasound and magnetic resonance imaging was excellent (κ=0.763-0.896, P< 0.001) in the detection of early soft tissue lesions (effusion or hemarthrosis, synovial hypertrophy, hemosiderin), excellent (κ=0.793, P< 0.001) in the detection of cartilage loss, poor (κ=0.133, P =0.132) in the detection of erosions and poor (κ=0.100, P=0.137) in the detection of subchondral cysts. The consistency of ultrasound and magnetic resonance imaging was good to excellent (κ=0.684-0.833, P< 0.001) in the score of early soft tissue lesions (effusion or hemarthrosis, synovial hypertrophy and hemosiderin) and poor to good (κ=0.145 -0.635, P< 0.001) in the score of advanced osteochondral lesions (cartilage loss and bone erosions). The inter-observer agreement was good to excellent (κ=0.676-0.870, P< 0.001) for early soft tissue lesions and moderate to excellent (κ=0.421- 0.751, P< 0.001) for advanced osteochondral lesions. The intra-observer agreement was good to excellent (κ=0.705-0.885, P< 0.001) for early soft tissue lesions and moderate to good (κ=0.532-0.732, P< 0.001) for advanced osteochondral lesions.
Conclusions: Ultrasound plays an important role in detecting early soft tissue changes (effusion or hemarthrosis, synovial hypertrophy, hemosiderin) and cartilage loss, which helps follow-up and guide clinical treatment.

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