| Part Ⅰ Application Value of Zero Time Echo Imaging MRI in Evaluation of Hemophilic ArthropathyObjective: To explore the application value of zero echo time(ZTE)technique in assessing cartilage damage in hemophilia arthropathy.Materials and Methods: A prospective collection of 34 patients with hemophilia arthropathy in our hospital from October 2018 to August 2019,including 29 knees,5 ankles and 2 elbows,a total of 27 knees were selected.Images of patients with joints were included in the study,aged 10 to 50 years,with an average of 28.86 ± 11.25 years.The ZTE sequence and conventional MR were used to scan the target joint.The 5-point method was used to evaluate the display of the knee joint.The knee joint was scored using the IPSG score method,showing the differences in knee scores for hemophilia with different sequences.Results:he consistency of PDWI and ZTE image quality scores of 27 patients with hemophilia knee arthritis was good,with Kappa values of 0.900 and 0.804,respectively.The routine MR and ZTE image quality of 27 patients with hemophilia knee arthritis were good.The scores were(2.30 ± 1.30)and(3.30 ± 1.24)points,and the difference was statistically significant(Z =-2.749,P = 0.006).In conventional MR,PDWI and T1 showed indistinct joint bone structure and contour;ZTE showed clear knee joint bone structure and clear and sharp contour.Conventional MR showed poor contours of cartilage and skeletal structure of knee arthritis of hemophilia,while ZTE sequence showed better cartilage destruction,which can meet the needs of clinical diagnosis.Conclusions: ZTE has advantages over conventional MR in displaying anatomy and cartilage destruction of hemophilia joints.It can improve the image display quality and accuracy of joint scores of target bones in hemophilia,and it is of great significance for accurate assessment of HA.Part Ⅱ Preliminary study on the application value of 3D-ASL and ESWAN technology in evaluating hemophilic arthropathyObjective: To explore the application value of 3D arterial spin labeling imaging(ASL)technology and three-dimensional enhanced gradient echo T2 * weighted angiography(ESWAN)in hemophilia arthropathy.Methods: Thirty-four patients with hemophilia arthropathy who were treated in our hospital from October 2018 to August 2019 were prospectively collected,including 29 knees,5 ankles,and 2 elbows.The ASL sequence,ESWAN sequence and conventional MR were used to scan the target joint.On the 3D post-processing workstation(AW4.6,GE Healthcare),Functool software was used to analyze and process the images obtained by 3D-ASL and ESWAN scanning,and obtain BF pseudo-color images,T2*,R2*.The ASL is where the synovial hyperplasia is obvious.The region with the highest blood flow(BF)is drawn to delineate the region of interest(ROI).Measure 3 times and take the average value.ESWAN carefully places the region of interest(ROI)in the middle of the patellar cartilage at the selected level.Correlation analysis was performed on the obtained BF,T2*,and R2* values with joint IPSG scores,and the differences between the conventional MR and ESWAN sequences were found to have a heme concentration.Results: On the basis of obtaining the BF map,the synovial perfusion value of the target joint was obtained by post-processing software of 26.12 ± 6.73(ml / 100 g · min),and the obtained ESWAN image was post-processed on the post-processing software to obtain T2* Value and R2* value are 0.38 ± 0.647 and 1.67 ± 1.903,respectively.The correlation coefficients between IPSG score and BF,T2*,R2* were 0.77,0.36,and 0.49,respectively.The ESWAN sequence was more sensitive than conventional MR found in hemosiderin,P <0.05.Conclusion: The ASL sequence can reflect the overall condition of the target joint of hemophilia,and its application in hemophilia joint disease has certain prospects.The ESWAN sequence can sensitively detect hemosiderin deposits,which is of great significance for the accurate assessment of hemophilic arthropathy. |
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