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Brakel BA, Sussman MS, Majeed H, Teitel J, Man C, Rayner T, Weiss R, Moineddin R, Blanchette V, Doria AS. T2 mapping magnetic resonance imaging of cartilage in hemophilia. Res Pract Thromb Haemost 2023; 7:102182. [PMID: 37767061 PMCID: PMC10520564 DOI: 10.1016/j.rpth.2023.102182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 09/29/2023] Open
Abstract
Background In hemophilia, recurrent hemarthrosis may lead to irreversible arthropathy. T2 mapping MRI may reflect cartilage changes at an earlier reversible stage of arthropathy as opposed to structural MRI. Objectives To evaluate interval changes of T2 mapping compared with the International Prophylaxis Study Group (IPSG) structural MRI scores of ankle cartilage in boys with hemophilia receiving prophylaxis. Methods Eight boys with hemophilia A (median age, 13; range, 9-17 years), 7 age- and sex-matched healthy boys (controls, median age, 15; range, 7-16 years). A multiecho spin-echo T2-weighted MRI sequence at 3.0T was used to obtain T2 maps of cartilage of boys with hemophilia and controls. Structural joint status was evaluated using the IPSG MRI score. Results T2 relaxation times of ankle cartilage increased significantly over time in both persons with hemophilia and controls (P = .002 and P = .00009, respectively). Changes in T2 relaxation time strongly correlated with changes in IPSG cartilage scores (rs = 0.93 to rs = 0.78 [P = .0007 to P = .023]), but not with changes in age (P = .304 to P = .840). Responsiveness of T2 relaxation times were higher than that of IPSG cartilage scores, with standardized response means >1.4 for T2 mapping in all regions-of-interest compared with 0.84 for IPSG cartilage scores. Baseline T2 relaxation time strongly correlated with timepoint 2 IPSG cartilage score (rs = 0.93 to rs = 0.82 [P = .001 to P = .012]) and T2 relaxation time (rs = 0.98 to rs = 0.88 [P = .00003 to P = .004]) changes in most regions-of-interest. Conclusion T2 mapping shows sensitivity to biochemical changes in cartilage prior to detectable damage using conventional MRI, offering potential for early detection of bleed-related cartilage damage in boys with hemophilia.
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Affiliation(s)
- Benjamin A. Brakel
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Marshall S. Sussman
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Haris Majeed
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Jerry Teitel
- Division of Hematology/Oncology, St Michael’s Hospital, Toronto, ON, Canada
| | - Carina Man
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Tammy Rayner
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Ruth Weiss
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Division of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Victor Blanchette
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrea S. Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Zhang L, Wei S, Li J, Wang P, Yinghui G. Value of 3.0T MRI T2 mapping combined with SWI for the assessment of early lesions in hemophilic arthropathy. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:1263-1271. [PMID: 36472890 DOI: 10.1080/16078454.2022.2147316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To explore the value of magnetic resonance imaging (MRI) T2 mapping combined with susceptibility-weighted imaging (SWI) in detecting early cartilage damage and joint bleeding in the hemophilic arthropathy (HA). METHODS 147 patients and 56 healthy controls were prospectively recruited. The knees were divided into groups A and B according to the criteria of the International Cartilage Repair Society (ICRS). The Regions of Interest (ROIs) of T2 mapping were drawn for the patella, lateral and medial femoral condyle, and lateral and medial tibial condyle. The T2 values were compared between the patients and control group using one-way ANOVA. The joint count data of International Prophylaxis Study Group (IPSG) scores of conventional and SWI sequences were statistically described using the composition ratio, and the rank sum test was used for the difference analysis. RESULTS Finally, there were 99 joints in the control group, 135 knees in group A, and 94 knees in group B. There was a significant difference between the T2 value in each subgroup. Comparison of T2 value groups in each cartilage partition, except for group A and group B of the patella, revealed significant differences (all P<0.05). SWI was likely more sensitive than conventional sequences in detecting hemosiderin deposits in hemophilic joints. In addition, the IPSG scores detected by the SWI were generally higher than those of conventional sequences. CONCLUSIONS MR T2 mapping combined with SWI has great potential to be used for detecting early cartilage damage and micro-hemosiderin deposition in hemophiliac arthropathies and developing preventative treatment plans.
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Affiliation(s)
- Lu Zhang
- Department of Medical Imaging, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Shufang Wei
- Department of Radiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, People's Republic of China
| | - Jiajia Li
- Department of Radiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, People's Republic of China
| | - Pengming Wang
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical College, Xinxiang, People's Republic of China
| | - Ge Yinghui
- Department of Medical Imaging, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
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Yoon H, Lim HJ, Kim J, Park KB, Kim HW, Lee MJ. T2 Relaxation Time Changes in the Distal Femoral Condylar Cartilage of Children and Young Adults with Discoid Meniscus. Cartilage 2022; 13:19476035221085142. [PMID: 35287484 PMCID: PMC9137297 DOI: 10.1177/19476035221085142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate compositional changes in the distal femoral condylar cartilage (FCC) of children and young adults with and without discoid meniscus by T2 relaxation time mapping. DESIGN We retrospectively reviewed knee magnetic resonance images including sagittal T2 maps of distal FCC performed in patients with or without discoid meniscus. Combined meniscal pathology such as degeneration or tears was also reviewed. Regions of interest were selected, and T2 relaxation time profiles were generated according to medial and lateral and FCC and according to weight-bearing and non-weight-bearing FCC. Nonparametric comparison tests using median values were performed. RESULTS Seventy-nine knees from 73 patients (2-20 years) including 45 knees with lateral discoid meniscus (discoid group) were studied. T2 values of FCC showed negative correlation with age in both the discoid and nondiscoid groups (P < 0.01), except for medial weight-bearing FCC. In the discoid group, T2 relaxation times of lateral weight-bearing FCC (median, 46.5 ms) were lower than those of lateral non-weight-bearing (median, 53.2 ms; P < 0.001) and medial weight-bearing (median, 50.5 ms; P = 0.012) FCC. Lateral weight-bearing FCC also showed lower T2 values than other areas in patients with meniscal pathology in the discoid group. However, T2 relaxation times did not differ between the discoid and nondiscoid groups in patients without meniscal pathology. CONCLUSIONS Children and young adults with discoid meniscus have lower T2 relaxation times in lateral weight-bearing FCC compared with non-weight-bearing or medial FCC, suggesting compositional changes have occurred in these patients.
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Affiliation(s)
- Haesung Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Ji Lim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jisoo Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kun-Bo Park
- Division of Pediatric Orthopaedic Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Woo Kim
- Division of Pediatric Orthopaedic Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi-Jung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea,Mi-Jung Lee, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Korea.
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