An MRI scale for assessment of haemophilic arthropathy from the International Prophylaxis Study Group |
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| Authors: | B Lundin M L Manco‐Johnson D M Ignas R Moineddin V S Blanchette A L Dunn S V Gibikote S N Keshava R Ljung M J Manco‐Johnson S F Miller G E Rivard A S Doria The International Prophylaxis Study Group |
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| Institution: | 1. Department of Clinical Sciences Lund, Division of Diagnostic Radiology and Center for Medical Imaging and Physiology, Lund University, Sk?ne University Hospital, , Lund, Sweden;2. Department of Radiology and Hemophilia & Thrombosis Center, University of Colorado, , Denver, CO, USA;3. Child Health Evaluative Sciences, The Hospital for Sick Children, , Toronto, Ontario, Canada;4. University of Toronto, Public Health, Family and Community Medicine, , Toronto, Ontario, Canada;5. Division of Pediatric Hematology/Oncology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, , Toronto, Ontario, Canada;6. Aflac Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta, Emory University School of Medicine, , Atlanta, GA, USA;7. Department of Radiology, Christian Medical College, , Vellore, Tamil Nadu, India;8. Department of Paediatrics, Lund University, Sk?ne University Hospital, , Malm?‐Lund, Sweden;9. Department of Pediatrics and the Hemophilia & Thrombosis Center, University of Colorado, , Denver, CO, USA;10. St. Jude Children's Research Hospital, , Memphis, TN, USA;11. CHU Sainte Justine, University of Montreal, , Montreal, Quebec, Canada;12. Department of Diagnostic Imaging, The Hospital for Sick Children, , Toronto, Ontario, Canada |
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| Abstract: | Evaluation of prophylactic treatment of haemophilia requires sensitive methods. To design and test a new magnetic resonance imaging (MRI) scale for haemophilic arthropathy, two scales of a combined MRI scoring scheme were merged into a single scale which includes soft tissue and osteochondral subscores. Sixty‐one joint MRI's of 46 patients with haemophilia were evaluated by four radiologists using the new and older scales. Forty‐six of the joints were evaluated using two X‐ray scales. For all MRI scores, interreader agreement and correlations with X‐ray scores and lifetime number of haemarthroses were analysed. The interreader agreement intraclass correlation coefficient was 0.82, 0.89 and 0.88 for the soft tissue and osteochondral subscores and the total score, as evaluated according to the new MRI scale, compared to 0.80 and 0.89 as for the older scales. The total score and osteochondral subscore according to the new scale, as well as scores according to the older scales were correlated (P < 0.01) with number of haemarthroses (Spearman correlation 0.35–0.68) and with the X‐ray scores (Spearman correlation 0.40–0.76), but no correlation (P > 0.05) was found between the soft tissue subscore of the new MRI scale and the X‐ray scores. The new MRI scale is simpler to apply than the older and has similar reader reliability and correlation with lifetime number of haemarthroses, and by separating soft tissue and osteochondral changes it gives additional information. The new scale is useful for analyses of early and moderate stages of arthropathy, and may help to evaluate prophylactic haemophilia treatment. |
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| Keywords: | factor VIII
factor IX
haemophilia haemophilic arthropathy
MRI
prophylaxis |
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