Abstract

BackgroundIntra-articular blood causes irreversible joint damage, whilst clinical differentiation between haemorrhagic joint effusion and other effusions can be challenging. An accurate non-invasive method for the detection of joint bleeds is lacking. The aims of this phantom study were to investigate whether magnetic resonance imaging (MRI) T1 and T2 mapping allows for differentiation between simple and haemorrhagic joint effusion and to determine the lowest blood concentration that can be detected.MethodsSolutions of synovial fluid with blood concentrations ranging from 0 to 100% were scanned at 1.5, 3, and 7 T. T1 maps were generated with an inversion recovery technique and T2 maps from multi spin-echo sequences. In both cases, the scan acquisition times were below 5 min. Regions of interest were manually drawn by two observers in the obtained T1 and T2 maps for each sample. The lowest detectable blood concentration was determined for all field strengths.ResultsAt all field strengths, T1 and T2 relaxation times decreased with higher blood concentrations. The lowest detectable blood concentrations using T1 mapping were 10% at 1.5 T, 25% at 3 T, and 50% at 7 T. For T2 mapping, the detection limits were 50%, 5%, and 25%, respectively.ConclusionsT1 and T2 mapping can detect different blood concentrations in synovial fluid in vitro at clinical field strengths. Especially, T2 measurements at 3 T showed to be highly sensitive. Short acquisition times would make these methods suitable for clinical use and therefore might be promising tools for accurate discrimination between simple and haemorrhagic joint effusion in vivo.

Highlights

  • Intra-articular blood causes irreversible joint damage, whilst clinical differentiation between haemorrhagic joint effusion and other effusions can be challenging

  • Clinical symptoms of joint bleeding, such as pain, swelling, and reduced functionality, are not specific for joint bleeding as these are observed in different joint conditions like arthritis, osteoarthritis, and other arthropathies as well [4,5,6]

  • We investigated the potential of quantitative T1 and T2 relaxometry magnetic resonance imaging (MRI) protocols as non-invasive tools to differentiate between simple and haemorrhagic joint effusion at 1.5, 3, and 7 T

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Summary

Introduction

Intra-articular blood causes irreversible joint damage, whilst clinical differentiation between haemorrhagic joint effusion and other effusions can be challenging. An accurate non-invasive method for the detection of joint bleeds is lacking The aims of this phantom study were to investigate whether magnetic resonance imaging (MRI) T1 and T2 mapping allows for differentiation between simple and haemorrhagic joint effusion and to determine the lowest blood concentration that can be detected. Clinical symptoms of joint bleeding, such as pain, swelling, and reduced functionality, are not specific for joint bleeding as these are observed in different joint conditions like arthritis, osteoarthritis, and other arthropathies as well [4,5,6]. Being able to distinguish between a joint bleed and another cause of joint effusion is clinically relevant, especially in patients with bleeding disorders like haemophilia, since the different diagnoses require different treatments [4, 11, 12]

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