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3T 磁敏感加权成像对血友病患者关节内含铁血黄素沉积的检出作用。

Contribution of 3-T Susceptibility-Weighted MRI to Detection of Intraarticular Hemosiderin Accumulation in Patients With Hemophilia.

机构信息

1 Department of Radiology, Ondokuz Mayis University Faculty of Medicine, 55139 Atakum, Samsun, Turkey.

2 Department of Biomedical Statistics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.

出版信息

AJR Am J Roentgenol. 2018 May;210(5):1141-1147. doi: 10.2214/AJR.17.18594. Epub 2018 Feb 22.

Abstract

OBJECTIVE

The purpose of this study was to assess the feasibility of 3-T susceptibility-weighted imaging (SWI) for detecting intraarticular hemosiderin accumulation in patients with hemophilia.

SUBJECTS AND METHODS

Forty-one joints in 24 patients with hemophilia were imaged with conventional MRI and SWI sequences. Two experienced musculoskeletal radiologists and one general radiologist (reader 3) interpreted the images for hemosiderin accumulation. The final decision was determined in consensus by readers 1 and 2 using both conventional MRI and SWI sequences. The diagnostic consistencies of each MRI sequence with the reference and pairwise agreements between interpreters were assessed.

RESULTS

For conventional MRI sequences, the diagnostic consistencies of the two experienced musculoskeletal radiologists with the reference were substantial (κ = 0.63 and 0.62), whereas the consistency of the general radiologist with the reference was moderate (κ = 0.47). The SWI interpretations of all readers had almost perfect agreement with the reference (κ = 1, κ = 1, κ = 0.97). Interobserver agreement also improved at SWI interpretations.

CONCLUSION

SWI contributes to more accurate grading of intraarticular hemosiderin accumulation than is achieved with conventional MRI sequences.

摘要

目的

本研究旨在评估 3T 磁敏感加权成像(SWI)检测血友病患者关节内含铁血黄素沉积的可行性。

材料和方法

对 24 例血友病患者的 41 个关节进行常规 MRI 和 SWI 序列成像。两名有经验的肌肉骨骼放射科医生和一名普通放射科医生(读者 3)对含铁血黄素沉积进行了图像解读。读者 1 和 2 使用常规 MRI 和 SWI 序列对图像进行解读,最终的决定由他们两人共同确定。评估了每个 MRI 序列与参考的诊断一致性以及解释者之间的两两一致性。

结果

对于常规 MRI 序列,两名有经验的肌肉骨骼放射科医生与参考的诊断一致性较高(κ=0.63 和 0.62),而普通放射科医生与参考的一致性为中等(κ=0.47)。所有读者的 SWI 解读与参考几乎完全一致(κ=1,κ=1,κ=0.97)。SWI 解读的观察者间一致性也有所提高。

结论

与常规 MRI 序列相比,SWI 有助于更准确地评估关节内含铁血黄素沉积。

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