Objective: To evaluate the value of enhanced magnetic resonance imaging (MRI) on the assessment of synovial hyperplasia and International Prophylaxis Study Group (IPSG) score of hemophilic arthropathy (HA). Methods: This was a retrospective case series study. Briefly, 54 joints of 46 male patients with hemophilia type A and diagnosed with HA in Henan Provincial People's Hospital from August 2016 to September 2017 were selected. Plain and enhanced MRI were performed at the same time. The IPSG score of synovial hyperplasia and the total joint before and after enhancement were calculated, and the enhancement rate of the synovium and muscles at the same level were also calculated. The differences in synovial hyperplasia and joint total IPSG scores before and after enhancement were compared by paired rank sum test. The correlation between enhancement joint total IPSG score, synovial IPSG score, synovial enhancement rate, total joint bleeding number, course of disease, and Hemophilia Joint Health Score (HJHS) score were analyzed by Spearman's correlation analysis. Results: Enhanced MRI could more clearly show synovial hyperplasia and ensure better accuracy of joint total IPSG score (Z=-2.24, P=0.025). The enhancement extent of synovial hyperplasia was higher than that of the same level muscle. There was no correlation between synovial enhancement rate and total number of joint bleeding, course of disease, and HJHS score. After enhancement, the joint total IPSG score was highly positively correlated with the total number of joint bleeding and the disease course (r=0.96, 0.84, P<0.001) and moderately positively correlated with the HJHS score (r=0.58, P<0.001). The enhanced synovial IPSG score showed a low positive correlation with the total number of joint bleeding and the disease course (r=0.37, 0.36, P=0.006, 0.008), but no correlation with HJHS score. Conclusion: Enhanced MRI can provide accurate imaging of synovial hyperplasia of HA and make joint IPSG score more accurate.
目的： 探讨磁共振（MRI）增强对血友病性关节病（HA）滑膜增生的评估及国际血友病预防治疗研究小组（IPSG）评分的影响。 方法： 病例系列研究。选取2016年8月至2017年9月在河南省人民医院确诊为HA的46例男性血友病A患者的54个关节，同时行MRI平扫和增强扫描。对每个关节行增强前后的滑膜增生及关节总IPSG评分，并计算滑膜、同层面肌肉的强化率。用配对秩和检验比较增强前后滑膜增生、关节总IPSG评分的差异。对增强后关节总IPSG评分、滑膜IPSG评分、滑膜强化率与关节总出血次数、病程、血友病关节健康评分（HJHS）进行Spearman相关性分析。 结果： 增强MRI能更清楚显示滑膜增生并使关节总IPSG评分更准确（Z=-2.24，P=0.025）。增生滑膜强化幅度高于同层肌肉。滑膜强化率与关节总出血次数、病程及HJHS评分无相关性。增强后关节总IPSG评分与关节总出血次数、病程呈高度正相关（r=0.96、0.84，P<0.001），与HJHS评分呈中度正相关（r=0.58，P<0.001）；增强后滑膜IPSG评分与关节总出血次数、病程呈低度正相关（r=0.37、0.36，P=0.006、0.008），与HJHS评分无相关性。 结论： 增强MRI能为HA的滑膜增生提供精准显影，并使关节IPSG评分更准确。.