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The diagnostic value of susceptibility-weighted imaging for identifying acute intraarticular hemorrhages

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Abstract

Purpose

To evaluate the diagnostic performance of susceptibility-weighted imaging (SWI) in identifying acute intraarticular hemorrhages and differentiating blood from other types of joint effusions.

Methods

Thirty-two patients (21 men, 11 women; mean age 38.7 ± 16.5 SD) clinically suspected of having joint effusion were prospectively included. All the patients underwent both conventional MRI and SWI. Two radiologists independently reviewed the conventional MRI images and scored the likelihood of intraarticular hemorrhage using a 5-level scoring system. Immediately thereafter, SWI images of each patient were also provided for the radiologists, and the scoring was repeated evaluating the conventional MRI and SWI images together. The patients underwent joint aspiration or surgical operation as the reference standard. The area under the curve (AUC) of conventional MRI and conventional MRI + SWI methods were calculated and compared. The weighted kappa analysis was used to evaluate the interobserver agreement.

Results

Traumatic knee injury comprised the majority of study sample. Eighteen out of 32 of the patients were proven to have intraarticular hemorrhage. Using the conventional MRI, reader 1 and 2 achieved AUCs of 0.67 (p = 0.09) and 0.53 (p = 0.76), respectively. Following the addition of SWI, reader 1 and 2 achieved AUCs of 0.96 (p = 0.0001) and 0.95 (p = 0.0001), respectively, and interobserver agreement improved from Κ = 0.61 to Κ = 0.93. Accordingly, difference between the AUCs was 0.28 (p = 0.003) and 0.42 (p = 0.0001) for reader 1 and 2, respectively.

Conclusions

If confirmed by future studies, SWI enables the reliable and accurate diagnosis of acute intraarticular hemorrhages.

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Authors and Affiliations

  1. Department of Radiology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

    Ali Akhavi Milani, Mohammad Hossein Daghighi, Mohammad Mirza-Aghazadeh-Attari, Javad Jalili & Masoud Mahmoudpour

  2. Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, USA

    Shadi Daghighi

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  1. Ali Akhavi Milani
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  2. Mohammad Hossein Daghighi
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Correspondence to Shadi Daghighi.

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This study was approved by the ethics committee of Tabriz University of Medical Sciences (approval number: IR.TBZMED.REC.1399.870).

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Informed written consent was obtained from the patient included in the study.

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Akhavi Milani, A., Daghighi, M.H., Mirza-Aghazadeh-Attari, M. et al. The diagnostic value of susceptibility-weighted imaging for identifying acute intraarticular hemorrhages. Skeletal Radiol 51, 1777–1785 (2022). https://doi.org/10.1007/s00256-022-04016-6

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