Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T2 Mapping

Haris Majeed; Humayun Ahmed; Marshall S Sussman; Christopher Macgowan; Tammy Rayner; Ruth Weiss; Brian M Feldman; Andrea S Doria

doi:10.1002/jmri.27406

Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T₂ Mapping

J Magn Reson Imaging. 2021 Mar;53(3):827-837. doi: 10.1002/jmri.27406. Epub 2020 Nov 2.

Authors

Haris Majeed¹, Humayun Ahmed¹, Marshall S Sussman², Christopher Macgowan³, Tammy Rayner³, Ruth Weiss³, Brian M Feldman^{4

5

6}, Andrea S Doria^{1

2

3}

Affiliations

¹ Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
² Department of Medical Imaging, University Health Network and University of Toronto, Toronto, Ontario, Canada.
³ Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁴ Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Department of Pediatrics, Faculty of Medicine, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada.
⁶ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

PMID: 33135834
DOI: 10.1002/jmri.27406

Abstract

Background: Persons with hemophilia experience hemarthrosis, which can lead to cartilage degeneration, causing physical impairment. MRI T₂ mapping has the potential to be used as a tool to evaluate early arthropathic changes and cartilage degeneration in patients with hemophilia.

Purpose: To assess the value of MRI-T₂ mapping as a tool for investigating the cartilage status of children and adolescents with hemophilic arthropathy.

Study type: Prospective, cross-sectional.

Subjects: Twenty-eight boys with hemophilia (aged 5-17 years) and 23 healthy boys (aged 7-17 years).

Field strength/sequences: A multiecho spin-echo T₂ -weighted gradient echo sequence was used on a 3.0T magnet.

Assessment: MRI-T₂ maps of ankle (tibia-talus) (n = 19) or knee (femur-tibia) (n = 9) cartilage were assessed in hemophilia and healthy groups. An anatomically-based MRI score was also assigned to each ankle/knee.

Statistical tests: Pearson's correlation coefficient (r), linear regression, intraclass correlation coefficient (ICC), and analysis of variance (ANOVA) test.

Results: Negative associations between age and ankle/knee cartilage T₂ relaxation times were found in hemophilia (r = -0.72 [P = 0.03] to -0.55 [P = 0.01]) and healthy (r = -0.84 [P < 0.001] to -0.55 [P = 0.20]) groups. There were nonsignificant associations between ankle cartilage T₂ relaxation times and MRI scores (r = -0.15 [P = 0.54] to 0.31 [P = 0.19]).

Data conclusion: Results of this clinical investigation emphasize the potential importance of MRI-T₂ maps as a tool to understand the functional status of cartilage in children and adolescents with hemophilic arthropathy, while holding promise for the detection of early cartilage degeneration prior to macroscopic characterization by conventional MRI. MRI-T₂ mapping may provide novel information that is not reflected in the anatomically-based MRI scoring system.

Level of evidence: 3 TECHNICAL EFFICACY STAGE: 2.

Keywords: arthropathy; cartilage; children; hemophilia; magnetic resonance imaging.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cartilage, Articular* / diagnostic imaging
Child
Child, Preschool
Cross-Sectional Studies
Humans
Knee Joint / diagnostic imaging
Magnetic Resonance Imaging
Male
Prospective Studies