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Value of Contrast-enhanced Ultrasound in Evaluating Synovitis and Predicting Recurrent Joint Bleeding of Hemophilia

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Abstract

Objective

Contrast-enhanced ultrasound (CEUS) is advantageous for evaluating microcirculation, and has been applied to assess arthritis in previous studies. However, CEUS examinations have not been studied for hemophilia arthritis. Hemophilia arthritis is different from other arthritis, because it is induced by spontaneous joint bleeding. Hence, CEUS may have special value in evaluating hemophilia arthritis. The present study assessed the value of CEUS in evaluating synovial hypertrophy and predicting recurrent joint bleeding in severe hemophilia A patients.

Methods

From August 2016 to January 2017, 81 severe hemophilia A patients, who were referred to our hospital for ultrasound joint assessment with conventional ultrasound, were enrolled. Among these 81 patients, 46 patients consented for CEUS examinations on the same day.

Results

Compared to color Doppler flow imaging (CDFI), four more joints presented with a blood flow signal under CEUS mode. In addition, the synovial hypertrophy measured by CEUS was thicker than that measured by conventional ultrasound. The ultrasound scores (including the total grey-scale ultrasound score, joint effusion/hemarthrosis, synovial hypertrophy, CDFI semi-quantitative score, and CEUS semi-quantitative score) were significantly higher in the joint bleeding group than in the no joint bleeding group (P<0.05). Furthermore, these ultrasound scores were positively correlated with the joint bleeding frequency, and had the highest correlation with the CEUS score (r=0.620, P<0.05).

Conclusion

CEUS can more accurately assess the degree of synovial hypertrophy and vascularization, and diagnose synovitis, when compared to conventional ultrasound. In addition, CEUS appears to be essential for evaluating the possibility of recurrent joint bleeding, and providing more reliable evidence for individualized treatment.

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Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine Ultrasonics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Fei Ma, Ya-ru Zhang, Hao Liu, Wan-xian Luo, Li Zhang, Mei Yi, Yang Gao, Wei-zhen Wang & Ying-jia Li

  2. Hematology and Lab Medicine Divisions, Children Hospital of Eastern Ontario, Ottawa, K1H 8L1, Canada

    Koon Hung Luke

  3. Department of Ultrasound, The Second People’s Hospital of Shenzhen, Shenzhen, 518025, China

    Li-ling Xiao

  4. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Shi-qiu Qiu & Jing Sun

  5. Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Xiao-qin Feng

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  1. Fei Ma
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Corresponding authors

Correspondence to Jing Sun or Ying-jia Li.

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The authors declare that they have no conflicts of interest regarding the publication of this manuscript.

Additional information

The study was financially supported by the Project of New Technology and New Business of Nanfang Hospital, Southern Medical University (No. 2016018).

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Ma, F., Zhang, Yr., Luke, K.H. et al. Value of Contrast-enhanced Ultrasound in Evaluating Synovitis and Predicting Recurrent Joint Bleeding of Hemophilia. CURR MED SCI 42, 439–446 (2022). https://doi.org/10.1007/s11596-022-2520-9

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  • DOI: https://doi.org/10.1007/s11596-022-2520-9

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