Ozülker Tamer, Ozülker Filiz, Derin Esin, Altun Mehmet, Aydoğan Gönül, Türkkan Emine, Adaş Müjdat, Tonbul Murat, Ozpaçacı Tevfik, Sezgin Funda, Değirmenci Hülya
Okmeydanı Training Hospital, Nuclear Medicine, İstanbul, Turkey.
Mol Imaging Radionucl Ther. 2011 Aug;20(2):38-44. doi: 10.4274/MIRT.25. Epub 2011 Aug 1.
We aimed to assess the role of Magnetic Resonance Imaging (MRI) and X-Ray in the evaluation of response to radiosynovectomy (RS) in patients with hemophilic arthropathy.
Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15) were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90) was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186) injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention.
During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%). The Pettersson scores worsened in 1/11 (9%), remained unchanged in 9/11 (81.8%), and improved in 1/11 (9%) joints. At the 6-month follow-up, the MRI score worsened in one (9%) and was unchanged in 10/11 joints (90.9%).
MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don't show correlation with the therapeutic response Conflict of interest:None declared.
我们旨在评估磁共振成像（MRI）和X线在评估血友病性关节病患者放射性滑膜切除（RS）反应中的作用。
本研究纳入了11例血友病性关节病患者，平均年龄11.7岁（范围7 - 15岁）。向10个膝关节关节腔内注射148 - 185 MBq的硅酸钇90（Y - 90），1例患者踝关节接受关节腔内注射74 MBq铼186（Re - 186）治疗。在进行放射性滑膜切除术前，采用标准技术获取目标关节的前后位和侧位普通X线片。患者在RS术后6个月进行随访MRI和X线检查。利用Pettersson血友病性关节病量表对普通X线片上的关节状况进行分期，并根据丹佛评分对MRI检查的关节进行分类。通过比较干预前后的平均出血次数对RS的疗效进行临床评估。
在RS术后6个月的随访期内，6个关节（54.5%）的关节积血次数较前6个月减少了75%或更多。Pettersson评分在1/11（9%）的关节中恶化，在9/11（81.8%）的关节中保持不变，在1/11（9%）的关节中得到改善。在6个月随访时，MRI评分在1个关节（9%）中恶化，在10/11（90.9%）的关节中保持不变。
对于血友病患者关节疾病的评估和随访，MRI是比普通X线摄影更敏感的工具，但两种方法均与治疗反应无相关性。利益冲突：无申报。
