Andrea S. Doria MD, Presenter: Nothing to Disclose

Bjorn Lundin MD, Abstract Co-Author: Nothing to Disclose

Ray F. Kilcoyne MD, Abstract Co-Author: Nothing to Disclose

Rachelle Nuss MD, Abstract Co-Author: Nothing to Disclose

Stephen Franklin Miller MD, Abstract Co-Author: Nothing to Disclose

Paul Sheppard Babyn MD, Abstract Co-Author: Nothing to Disclose

to compare the reliability of two MRI scoring systems for hemophilic arthropathy. The progressive system is based on a method that displays the most severe change and the additive system is based on a process that combines the integer of osteochondral and soft tissue-related changes.Effective treatment of hemophilic arthropathy requires a detailed evaluation of the joint integrity. Methodological assessment of MRI scores is needed to assure reproducibility of measurements when comparing results of clinical trials.

32 1.5 T MRI examinations of knees (N=15) and ankles (N=17) of boys with hemophilia, age range, 4-16 years, performed at 2 centres (Toronto, n=20 and Sweden, n=12) were independently read by 4 blinded radiologists at 2 occasions. Eleven children were younger than 9 years old and 21 were older. Sagittal and coronal gradient echo (MPGR, 3D FLASH with fat saturation) images were obtained.

35.3% and 26.7% of the ankle and knee studies respectively presented with osteochondral abnormalities at the time of MRI examination. The two scoring systems demonstrated an excellent inter-reader (progressive, 0.88; additive (A,e,s,h components), 0.87) and intra-reader (progressive, 0.92; additive (A,e,s,h components), 0.93) overall reliability by means of intraclass correlation coefficients (ICCs). Although the numerical values of ICCs were slightly higher for knees as compared to ankles (progressive/additive, inter-reader ICC for knees, 0.92/0.88, for ankles, 0.85/0.86, intra-reader ICC for knees, 0.95/0.94, for ankles, 0.92/0.94) and for older children as compared to younger children (progressive/additive, inter-reader ICC for children >=9, 0.91/0.88, for children =9, 0.95/0.94, for children <9, 0.89/0.88), all values fell within excellent inter- and intra-reliability categories.

Although providing different types of information, both MRI scoring systems demonstrated a comparable reliability. This result constitutes the basis for the future development of a combined scoring system incorporating progressive and additive components which may be standardized for imaging assessment of hemophilic arthropathy around the world.

Doria, A, Lundin, B, Kilcoyne, R, Nuss, R, Miller, S, Babyn, P, Reliability of Progressive and Additive MRI Scoring Systems for Evaluation of Hemophilic Arthropathy in Children: International MRI Working Group.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4417144.html