Value of International Prophylaxis Study Group (IPSG) magnetic resonance imaging scale system in the evaluation of hemophiliac arthropathy joint changes in children

doi:10.3969/j.issn.1006-7795.2013.03.004

Abstract

Abstract:

Objective The International Prophylaxis Study Group (IPSG) magnetic resonance imaging (MRI) scale was used to evaluate the severity of haemophilic arthropathy joints and analyze the correlation of MRI performance and clinical factors. Methods Sagittal and coronal T1W, T2W and T2W FFE MRI images of knees, ankles and elbows were obtained from 22 joints of 18 boys who were clinically diagnosed hemophilia were studied ［age range from 2 to 15 years; mean (8.06±3.37) years］ with moderate and severe hemophilia diagnosed in our hospital. The severity of hemophilia from soft tissue and osteochondral domains with the IPSG MRI scale system was assessed.Results The soft tissue domain of 22 joints were appraised with regard to frequency of findings: effusion, 18/22(81.8%); synovial hypertrophy, 20/22(90.9%); hemosiderin deposition, 19/22(86.4%). The severity of soft tissue joint changes on MRI was mild, 9/22 (40.4%); moderate, 7/22(31.8%); and severe 6/22(27.3%), respectively. The severity of osteochondral joints changes on MRI was normal, 8/22(36.4%); mild, 3/22 (13.6%); moderate, 7/22(31.8%); and severe, 4/22(18.2%), respectively. The frequency of bone erosions was 14/22(63.6%),bone cysts, 9/22(40.9%),and cartilage loss, 14/22(63.6%). The intrareader reliability for each item of the IPSG MRI scale was excellent by Kappa analysis. The correlations between the osteochondral domain of the MRI scale and bleeding frequency as well as patients' age were moderate(r=0.501,P=0.018;r=0.557,P=0.007). The correlation between the IPSG final score and patients' age was also moderate(r=0.543,P=0.009). The correlation between age at first bleed and presence of subchondral cysts was moderate(r=-0.479,P=0.044)as well. Otherwise, no significant correlations were noted between items of the soft tissue domain and clinical factors(|r|<0.3).Conclusion The IPSG scoring system is highly reliable within readers' interpretation, is able to discriminate severity of joint changes in HA and provide detailed evaluation of soft tissue and osteochondral joint components. However, its correlation with clinical constructs is suboptimal.

Key words: hemophilia, joint diseases, magnetic resonance imaging

CLC Number:

R 554⁺.1

ZHANG Ningning, PENG Yun, WU Runhui, Andrea S. Doria, LIU Yue. Value of International Prophylaxis Study Group (IPSG) magnetic resonance imaging scale system in the evaluation of hemophiliac arthropathy joint changes in children[J]. Journal of Capital Medical University, 2013, 34(3): 342-347.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.03.004

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I3/342

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