Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence

Abstract Background Repeated bleeding in hemophilic arthropathy (HA) may result in severe degenerative changes and joint destruction. The gradient-recalled echo (GRE) sequence MR is proved to be the best method to detect hemosiderin deposition. However, MR is not widely available in developing count...

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Main Authors: Marcel Prasetyo, Ariel Elisa Mongan, Novie Amelia Chozie, Joedo Prihartono, Stefanus Imanuel Setiawan
Format: Article
Language:English
Published: SpringerOpen 2021-07-01
Series:Insights into Imaging
Subjects:
Online Access:https://doi.org/10.1186/s13244-021-01050-1
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author Marcel Prasetyo
Ariel Elisa Mongan
Novie Amelia Chozie
Joedo Prihartono
Stefanus Imanuel Setiawan
author_facet Marcel Prasetyo
Ariel Elisa Mongan
Novie Amelia Chozie
Joedo Prihartono
Stefanus Imanuel Setiawan
author_sort Marcel Prasetyo
collection DOAJ
description Abstract Background Repeated bleeding in hemophilic arthropathy (HA) may result in severe degenerative changes and joint destruction. The gradient-recalled echo (GRE) sequence MR is proved to be the best method to detect hemosiderin deposition. However, MR is not widely available in developing countries, including Indonesia. Some studies have proposed ultrasonography (US) as an alternative tool in evaluating hemophilic joint. However, there is still some disagreement on the ability of US to detect hemosiderin deposition. Objective To evaluate the association between US and GRE-sequence MR imaging in detecting hemosiderin deposition in hemophilic ankle joint. Material and methods A total of 102 sites from 17 ankle joints of 11 boys with severe hemophilia A underwent US examination using a high-frequency linear array transducer. GRE-sequence MR examination was performed in sagittal view consistent with the sites scanned by US. Both examinations were performed on the same day, but MR interpretation was performed blindly at different times. The association between US and GRE-sequences in detecting hemosiderin deposition was analyzed using McNemar’s test. Results Statistical analysis showed a significant association (p value < 0.001) between US and GRE MR in detecting hemosiderin deposition, but the association is weak (R = 0.26). Sensitivity and specificity of US for detecting hemosiderin deposition were 46.84% (95%CI: 35.51–58.40) and 95.65% (95%CI: 78.05–99.89), respectively, with positive predictive value 97.37% (95%CI: 84.29–99.61), negative predictive value 34.38% (95%CI: 29.50–39.60) and accuracy 57.84% (95%CI: 47.66–67.56). Conclusion There was a weak association between US and GRE-sequences in detecting hemosiderin deposition of hemophilic ankle joint. ​​
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spelling doaj.art-0d959e3383614fa394e3a6e0a5561d712022-12-21T18:22:34ZengSpringerOpenInsights into Imaging1869-41012021-07-011211710.1186/s13244-021-01050-1Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequenceMarcel Prasetyo0Ariel Elisa Mongan1Novie Amelia Chozie2Joedo Prihartono3Stefanus Imanuel Setiawan4Department of Radiology, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General HospitalDepartment of Radiology, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General HospitalDepartment of Pediatric, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General HospitalDepartement of Community Medicine, Faculty of Medicine, Universitas IndonesiaDepartment of Radiology, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General HospitalAbstract Background Repeated bleeding in hemophilic arthropathy (HA) may result in severe degenerative changes and joint destruction. The gradient-recalled echo (GRE) sequence MR is proved to be the best method to detect hemosiderin deposition. However, MR is not widely available in developing countries, including Indonesia. Some studies have proposed ultrasonography (US) as an alternative tool in evaluating hemophilic joint. However, there is still some disagreement on the ability of US to detect hemosiderin deposition. Objective To evaluate the association between US and GRE-sequence MR imaging in detecting hemosiderin deposition in hemophilic ankle joint. Material and methods A total of 102 sites from 17 ankle joints of 11 boys with severe hemophilia A underwent US examination using a high-frequency linear array transducer. GRE-sequence MR examination was performed in sagittal view consistent with the sites scanned by US. Both examinations were performed on the same day, but MR interpretation was performed blindly at different times. The association between US and GRE-sequences in detecting hemosiderin deposition was analyzed using McNemar’s test. Results Statistical analysis showed a significant association (p value < 0.001) between US and GRE MR in detecting hemosiderin deposition, but the association is weak (R = 0.26). Sensitivity and specificity of US for detecting hemosiderin deposition were 46.84% (95%CI: 35.51–58.40) and 95.65% (95%CI: 78.05–99.89), respectively, with positive predictive value 97.37% (95%CI: 84.29–99.61), negative predictive value 34.38% (95%CI: 29.50–39.60) and accuracy 57.84% (95%CI: 47.66–67.56). Conclusion There was a weak association between US and GRE-sequences in detecting hemosiderin deposition of hemophilic ankle joint. ​​https://doi.org/10.1186/s13244-021-01050-1Hemosiderin depositionHemophilic arthropathyUSGRE MR imaging
spellingShingle Marcel Prasetyo
Ariel Elisa Mongan
Novie Amelia Chozie
Joedo Prihartono
Stefanus Imanuel Setiawan
Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
Insights into Imaging
Hemosiderin deposition
Hemophilic arthropathy
US
GRE MR imaging
title Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
title_full Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
title_fullStr Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
title_full_unstemmed Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
title_short Hemosiderin deposition evaluation in hemophilic ankle joints: association between US finding and gradient-recalled echo MR imaging sequence
title_sort hemosiderin deposition evaluation in hemophilic ankle joints association between us finding and gradient recalled echo mr imaging sequence
topic Hemosiderin deposition
Hemophilic arthropathy
US
GRE MR imaging
url https://doi.org/10.1186/s13244-021-01050-1
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