Abstract Number: PB0591
Meeting: ISTH 2021 Congress
Background: Hemophilic arthropathy is a fundamental clinical problem in patients with hemophilia.
Aims: The purpose of this study was to develop a scale for the severity of hemophilic arthropathy based on MRI and US to evaluate the degree of joint involvement, as well as to determine the persistent active synovitis in patients after previous radiosynovectomy to select patients to further therapy approach.
Methods: The study group consists of 9 patients with examinations of 15 joints. All affected joints were evaluated in MRI using 3T system (Siemens; G) with dedicated protocol. Additional each joint was examined using US to assess synovial overgrowth and increase vascularization with utilization of mSMI® software (Cannon; J), which was used to improve the detection of low flow rate in case of synovitis without use of contrast medium. All patients had at least single session of RS, overall 32 RS were performed. Both techniques were used to objective evaluation of the potential regression after previous RS and as imaging follow-up..
Results: MRI indicated advanced hemophilic arthropathy with features of cartilage destruction in 10 joints, clinically all subjects with MRI positive scans had joint stiffness, additional in 3 cases bone marrow edema were observed without accompanying advanced arthropathy.
Thickened and overgrowth of synovium were detected in 8 cases of MRI. In US respectively all cases with synovial overgrowth were seen in the same localization as in MRI and all of them showed features of increased vascularization in mSMI, indicated active persistent synovitis. In 4 cases the vascularization and very high flow was seen in mSMI, rest of them had moderate vascular flow.
Conclusions: MRI With Very High Contrast Resolution Of Images Is An Excellent Method To Detect Structural Lesions In Affected Joint In Patients With Hemophilic Arthropathy After RS.
The Study Was Carried Out Thanks To A Grant From The SOBI Company.
To cite this abstract in AMA style:Walentowska-Janowicz M, Ćwikła JB, Brzewski M, Matysiak M, Łaguna P. Development of a Scale in the Diagnosis and Monitoring of Arthropathy in Patients with Hemophilia Using Ultrasound (US) and MRI: Initial Report [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/development-of-a-scale-in-the-diagnosis-and-monitoring-of-arthropathy-in-patients-with-hemophilia-using-ultrasound-us-and-mri-initial-report/. Accessed September 23, 2021.
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