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

• Published in: Insights into imaging Vol. 12; no. 1; p. 107
• Main Authors: Prasetyo, Marcel, Mongan, Ariel Elisa, Chozie, Novie Amelia, Prihartono, Joedo, Setiawan, Stefanus Imanuel
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 27.07.2021; Springer Nature B.V; SpringerOpen
• Subjects: Ankle; Deposition; Developing countries; Diagnostic Radiology; Evaluation; GRE MR imaging; Hemophilic arthropathy; Hemosiderin deposition; Imaging; Internal Medicine; Interventional Radiology; LDCs; Linear arrays; Magnetic resonance imaging; Medicine; Medicine & Public Health; Neuroradiology; Original; Original Article; Radiology; Statistical analysis; Ultrasound; United States > US; GRE MR imaging; Hemosiderin deposition; Hemophilic arthropathy; US
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-021-01050-1

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. ​​