Abstract Number: PB1033
Meeting: ISTH 2020 Congress
Background: Joint bleeding occurred in hemophilia patient can stimulate synovial hyperplasia and neoangiogenesis. Our earlier study suggest the evaluation of neovascularization would help predict the possibility of recurrent joint bleeding. Therefore, exploring the general rule for neovascularization in the synovium after joint bleeding may contribute to the therapy for preventing recurrent joint bleeding.
Aims: To find a sensitive tool to evaluate the neovascularization and general rule of neovascularization in the synovium after joint bleeding.
Methods: 29 severe hemophilia A patients with 41 joints underwent gray-scale ultrasound, Color Doppler Flow Imaging (CDFI), SMI and CEUS examinations. Clinical data were collected from routine practice. Semi-quantitative analysis was based on the displaying proportion of blood flow signal in the synovium .Quantitative parameters were used to analyze the progression of neovascularization in synovium at different time points (1W, 2W, 3W, 3W-3 months,> 3 months) after joint bleeding, and the correlation between quantitative parameters and the frequency of joint bleeding in the past six months were also studied.
Results: Compared with semi-quantitative scores of SMI and CDFI, CEUS showed increased scores in 33 and 38 joints selectively. SMI vascular index, CEUS peak intensity (PT), and area under the curve (AUC) all peaked in the third week after joint bleeding. Frequency of joint bleeding in the past six months was positively correlated with SMI vascular index, and PT, (r = 0.408-0.597), P < 0.05, while negatively correlated with TP, (r = -0.421), P < 0.05.
Conclusions: SMI and CEUS seems to be more sensitive than CDFI in evaluating neovascularization of synovial hyperplasia. Besides, the peak value of synovial neovascularization in the third week after joint bleeding correlates positively with the frequency of joint bleeding during the past six months. Therefore, accurate evaluation of the neovascularization and hyperplasia rule in the synovium may be beneficial in guiding targeted and individualized treatment.
To cite this abstract in AMA style:Li Y, Zhang Y, Xu C, Sun J, Gao Y, Liu H, Fei M. Value of Super Microvascular Imaging and Contrast-enhanced Ultrasound in Evaluating the Neovascularization of Synovial Hypertrophy in Hemophilia Joints [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/value-of-super-microvascular-imaging-and-contrast-enhanced-ultrasound-in-evaluating-the-neovascularization-of-synovial-hypertrophy-in-hemophilia-joints/. Accessed December 10, 2023.
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