The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy

Aydogan, Muzeyyen; ÖZPAÇACI, Tevfik; ÖZÜLKER, TAMER; DEĞİRMENCİ, Hülya; sezgin, funda hatice; DERİN, Esin; TONBUL, Murat; Altun, Mehmet; Türkkan, Emine; Ozulker, Filiz; adaş, müjdat

The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy

Tamer ÖZÜLKER, (Okmeydanı Eğitim Hastanesi, Nükleer Tıp Kliniği, İstanbul, Türkiye)

Filiz ÖZÜLKER, (Okmeydanı Eğitim Hastanesi, Nükleer Tıp Kliniği, İstanbul, Türkiye)

Esin DERİN, (Fatih Sultan Mehmet Hastanesi, Radyoloji Kliniği, İstanbul, Türkiye)

Mehmet ALTUN, (Okmeydanı Eğitim Hastanesi, Ortopedi Kliniği, İstanbul, Türkiye)

Gönül AYDOĞAN, (Bakırköy Kadın Hastalıkları ve Doğum Hastanesi, Çocuk Hematoloji Kliniği, İstanbul, Türkiye)

Emine TÜRKKAN, (Okmeydanı Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı Kliniği, İstanbul, Türkiye)

Müjdat ADAŞ, (Okmeydanı Eğitim Hastanesi, Ortopedi Kliniği, İstanbul, Türkiye)

Murat TONBUL, (Okmeydanı Eğitim Hastanesi, Ortopedi Kliniği, İstanbul, Türkiye)

Tevfik ÖZPAÇACI, (Okmeydanı Eğitim Hastanesi, Nükleer Tıp Kliniği, İstanbul, Türkiye)

FUNDA HATİCE SEZGİN, (Mimar Sinan Üniversitesi, Biyoistatiktik Anabilim Dalı, İstanbul, Türkiye)

Hülya DEĞİRMENCİ, (Okmeydanı Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, İstanbul, Türkiye)

Diğer Yazarlar

Molecular Imaging and Radionuclide Therapy

1 1

Yıl: 2011 Cilt: 20 Sayı: 2 Sayfa Aralığı: 38 - 44 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy

Öz:

Amaç: Hemofilik artropatili hastalarda radyosinovektomiye (RS) cevabın değerlendirilmesinde Manyetik Rezonans Görüntülemenin (MRG) ve direkt grafinin rolünü değerlendirmeyi amaçladık. Gereç ve Yöntemler: Yaş ortalamaları 11.7 (7-15) olan 11 hemofilik artropati hastası çalışmaya dahil edildi. On diz eklemine 148-185 MBq Yttrium 90 silicate (Y-90) intraartiküler olarak enjekte edildi ve bir hasta ayak bileğine intraartiküler 74 MBq Rhenium 186 (Re-186) enjekte edilerek tedavi edildi. RS’den önce hedef eklemlerin direkt grafileri ve MRG görüntüleri elde edildi. RS’den 6 ay sonra hastaların takip MRG ve direkt grafi çekimleri yapıldı. Eklemlerin direkt grafiyle evrelenmesinde Pettersson hemofilik artropati skalaları uygulandı ve incelenen eklemlerin MRG ile sınışandırılması Denver skorlarına göre yapıldı. RS’nin etkinliğinin klinik değerlendirilmesi ortalama kanamaların girişim öncesi ve sonrasıyla karşılaştırılmasıyla yapıldı. Bulgular: RS’den sonraki 6 aylık takipte 6 eklemde (%54.5), önceki 6 ayla karşılaştırıldığında hemartroz sayısında %75 ya da daha fazla iyileşme görüldü. Pettersson skorları 1/11 (%9) eklemde kötüleşti, 9/11 (%81.8) eklemde değişim göstermedi ve 1/11 (%9) eklemde iyiye gitti. Altı aylık takipte MRG skorları bir eklemde (%9) kötüleşti ve 10/11 (%90.9) eklemde değişim göstermedi. Sonuç: MRG, hemofilili hastalarda eklem hastalıklarını değerlendirmede ve takipte direkt grafiden daha hassas bir yöntemdir fakat her iki yöntem de tedavi cevabı ile korelasyon göstermezler. (MIRT 2011;20:38-44)

Anahtar Kelime:

Konular: Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

manyetik resonans görüntüleme ve direkt grafinin hemofilik artropatili hastalarda radyosinovektomiye Cevabın değerlendirilmesindeki rolü

Öz:

Objective: We aimed to assess the role of Magnetic Resonance Imaging (MRI) and X-Ray in the evaluation of response to radiosynovectomy (RS) in patients with hemophilic arthropathy. Material and Methods: Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15) were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90) was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186) injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention. Results: During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%). The Pettersson scores worsened in 1/11 (9%), remained unchanged in 9/11 (81.8%), and improved in 1/11 (9%) joints. At the 6-month follow-up, the MRI score worsened in one (9%) and was unchanged in 10/11 joints (90.9%). Conclusion: MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don’t show correlation with the therapeutic response. (MIRT 2011;20:38-44)

Anahtar Kelime:

Konular: Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Türkmen C, Zülflkar B, Tafler O, Tokmak H, Kílíçoglu O, Mudun A, Unal S, Adalet I, Cantez S. Radiosynovectomy in hemophilic synovitis: correlation of therapeutic response and blood-pool changes. Cancer Biother Radiopharm 2005;20:363-370.
2. Siegel ME, Siegel HJ, Luck JV Jr. Radiosynovectomy’s clinical aplications and cost effectiveness: A review. Semin Nucl Med 1997;27:364-371.
3. Fernandez-Palazzi F, Rivas S, Cibeira JL, Dib O, Viso R. Radioactive synoviorthesis in hemophilic hemarthrosis: Materials, techniques, and dangers. Clin Orthop Relat Res 1996;1:14-18.
4. Mathew P, Talbut DC, Frogameni A, Singer D, Chrissos M, Khuder S, Ohler S, Farley D, Michael C, Robinson MG. Isotopic synovectomy with P-32 in paediatric patients with haemophilia. Haemophilia 2000;6:547-555.
5. Rodriguez-Merchan EC. Radionuclide synovectomy (radiosynoviorthesis) in hemophilia: A very efficient and single procedure. Semin Thromb Hemost 2003;29:97-100.
6. Siegel HJ, Luck JV, Jr, Siegel ME, Quinones C. Phosphate-32 colloid radiosynovectomy in hemophilia: outcome of 125 procedures. Clin Orthop Relat Res 2001;409-417.
7. Silva M, Luck JV Jr, Siegel ME. 32P chromic phosphate radiosynovectomy for chronic hemophilic synovitis. Haemophilia 2001;2:40-49.
8. Chew EM, Tien SL, Sundram FX, Ho YK, Howe TS. Radionuclide synovectomy and chronic haemophilic synovitis in Asians: A retrospective study. Haemophilia 2003;9:632-637.
9. Krenisk E, Mikosch P, Gallowitsch HJ, Jesenko R, Just H, Kogler D, Gasser J, Heinisch M, Unterweger O, Kumnig G, Gomez I, Lind P. Clinical outcome of radiosynoviorthesis: A meta-analysis including 2190 treated joints. Nucl Med Commun 2002;23:683-688.
10. Van Kasteren ME, Novakova IR, Boerbooms AM, Lemmens JA. Longterm follow-up of radiosynovectomy with yttrium-90 silicate in haemophilic haemarthrosis. Ann Rheum Dis 1993;52:548-550.
11. Dawson TM, Ryan PF, Street AM, Robertson PL, Kalff V, Kelly MJ, Cicuttini FM. Yttrium synovectomy in haemophilic arthropathy. Br J Rheumatol 1994;33:351-356.
12. Boerbooms AM, Buijs WC, Danen M, van de Putte LB, Vandenbroucke JP. Radiosynovectomy in chronic synovitis of the knee joint in patients with rheumatic arthritis. Eur J Nucl Med 1985;10:446-449.
13. Nuss R, Kilcoyne RF, Geraghty S, Shroyer AL, Rosky JW, Mawhinney S, Wiedel J, Manco-Johnson M. MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage. Haemophilia 2000;6:162-169.
14. Pettersson H, Ahlberg A, Nilsson IM. A radiologic classification of hemophilic arthropathy. Clin Orthop Relat Res 1980;149:153-159.
15. Arnold WD, Hilgartner MW. Hemophilic arthropathy. Current concepts of pathogenesis and management. J Bone Joint Surg Am 1977;59:287-305.
16. Kilcoyne RF, Nuss R. Radiological evaluation of hemophilic arthropathy. Semin Thromb Hemost 2003;29:43-48.
17. Funk MB, Schmidt H, Becker S, Escuriola C, Klarmann D, Klingebiel T, Kreuz W. Modified magnetic resonance imaging score compared withorthopaedic and radiological scores for the evaluation of haemophilic arthropathy. Haemophilia 2002;8:98–103.
18. Soler R, Lopez-Fernandez F, Rodriguez E, Marini M. Hemophilic arthropathy. A scoring system for magnetic resonance imaging. Eur Radiol 2002;12:836-843.
19. Dobón M, Lucía JF, Aguilar C, Mayayo E, Roca M, Solano V, Peña A, Giralt M, Ferrández A. Value of magnetic resonance imaging for the diagnosis and follow-up of haemophilic arthropathy. Haemophilia 2003;9:76-85.
20. Nuss R, Kilcoyne R. The MRI Atlas of Hemophilic Arthropathy. New York: Professional Publishing Group, Ltd, 2002.
21. Lundin B, Pettersson H, Ljung R. A new magnetic resonance imaging scoring method for assessment of haemophilic arthropathy. Haemophilia 2004;10:383–389.
22. Lundin B, Ljung R, Pettersson H; European Paediatric Network for Haemophilia Management (PEDNET). MRI scores of ankle joints in children with haemophilia – comparison with clinical data. Haemophilia 2005;11:116–122.
23. Nuss R, Kilcoyne R, Rivard G, Murphy J. Late clinical, plain X-ray and magnetic resonance imaging findings in haemophilic joints treated with radiosynoviorthesis. Haemophilia 2000;6(suppl 6)658-663.
24. Funk MB, Schmidt H, Kreuz W. Evaluation of haemophilic arthropathy--a comparison of MRI and Pettersson score. Rofo 2002;174(suppl 3)314-320.
25. Rivard GE, Girard M, Belanger R Jutras M, Guay JP, Marton D. Synoviorthesis with colloidal P32 chromic phosphate for the treatment of hemophilic arthropathy. J Bone Joint Surg 1994;76(suppl 4): 482-488.
26. Lofqvist T, Pettersson C. Synoviorthesis in young patients with hemophilia and inhibitory antibodies. Pediatric Hematol Oncol 1992;9(2):167-170.
27. Siegel H, Luck J, Siegel M, Quines C, Anderson E. Hemarthrosis and synovitis associated with hemophilia:Clinical use of P-32 chromic phosphate synoviorthesis for treatment. Radiology 1994;190:257-261.
28.Fernandez-Palazzi F. Treatment of acute and chronic synovitis by nonsurgical means. Haemophilia 1998;4:518-523.
29. Ahlberg A. Radioactive gold in the treatment of chronic synovial effusion in hemophilia. Proceedings of the VII Congress of the World Federation of Haemophilia, Teheran. Amsterdam: Excerpta Medica 1971:212-215.
30. Erken EH. Radiocolloids in the management of hemophilic arthropathy in children and adolescents. Clin Orthop Relat Res 1991;264:129-135.
31. Rodriguez-Merchan EC, Caviglia HA, Magallon M, Perez-Bianco R. Chemical synovectomy vs. radioactive synovectomy for the treatment of chronic haemophilic synovitis: a prospective short-term study Haemophilia 1997;3:118-122.
32. Ahlberg A, Pettersson H. Synoviorthesis with radioactive gold in hemophiliacs. Acta Orthop Scand 1979;50:513-517.
33. Kavakli K, Aydo¤du S, Omay SB, Duman Y, Taner M, Capaci K, Memifl A, Balkan C, Karapinar D. Long-term evaluation of radioisotope synovectomy with Yttrium 90 for chronic synovitis in Turkish haemophiliacs:Izmir experience. Haemophilia 2006;12(1):28–35.
34. Kavakli K, Aydogdu S, Taner M, Duman Y, Balkan C, Karapinar DY, Saydam G, Capaci K, Oktay A. Radioisotope synovectomy with rhenium186 in haemophilic synovitis for elbows, ankles and shoulders. Haemophilia 2008;14:518–523.
35. Fellinger K, Schmid J. Die Lokale Behandlung der rheumatischen Erkrankungen (Local therapy of rheumatic diseases). Wien Z Inn Med 1952;33:351-363.
36. DE LA Corte-Rodriguez H, Rodriguez-Merchan EC, Jimenez-Yuste V. Radiosynovectomy in hemophilia: quantification of its effectiveness through the assessment of 10 articular parameters. J Thromb Haemost 2011;9:928-935.

APA	ÖZÜLKER T, Ozulker F, DERİN E, Altun M, Aydogan M, Türkkan E, adaş m, TONBUL M, ÖZPAÇACI T, sezgin f, DEĞİRMENCİ H (2011). The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. , 38 - 44.
Chicago	ÖZÜLKER TAMER,Ozulker Filiz,DERİN Esin,Altun Mehmet,Aydogan Muzeyyen,Türkkan Emine,adaş müjdat,TONBUL Murat,ÖZPAÇACI Tevfik,sezgin funda hatice,DEĞİRMENCİ Hülya The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. (2011): 38 - 44.
MLA	ÖZÜLKER TAMER,Ozulker Filiz,DERİN Esin,Altun Mehmet,Aydogan Muzeyyen,Türkkan Emine,adaş müjdat,TONBUL Murat,ÖZPAÇACI Tevfik,sezgin funda hatice,DEĞİRMENCİ Hülya The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. , 2011, ss.38 - 44.
AMA	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. . 2011; 38 - 44.
Vancouver	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. . 2011; 38 - 44.
IEEE	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H "The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy." , ss.38 - 44, 2011.
ISNAD	ÖZÜLKER, TAMER vd. "The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy". (2011), 38-44.

APA	ÖZÜLKER T, Ozulker F, DERİN E, Altun M, Aydogan M, Türkkan E, adaş m, TONBUL M, ÖZPAÇACI T, sezgin f, DEĞİRMENCİ H (2011). The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. Molecular Imaging and Radionuclide Therapy, 20(2), 38 - 44.
Chicago	ÖZÜLKER TAMER,Ozulker Filiz,DERİN Esin,Altun Mehmet,Aydogan Muzeyyen,Türkkan Emine,adaş müjdat,TONBUL Murat,ÖZPAÇACI Tevfik,sezgin funda hatice,DEĞİRMENCİ Hülya The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. Molecular Imaging and Radionuclide Therapy 20, no.2 (2011): 38 - 44.
MLA	ÖZÜLKER TAMER,Ozulker Filiz,DERİN Esin,Altun Mehmet,Aydogan Muzeyyen,Türkkan Emine,adaş müjdat,TONBUL Murat,ÖZPAÇACI Tevfik,sezgin funda hatice,DEĞİRMENCİ Hülya The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. Molecular Imaging and Radionuclide Therapy, vol.20, no.2, 2011, ss.38 - 44.
AMA	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. Molecular Imaging and Radionuclide Therapy. 2011; 20(2): 38 - 44.
Vancouver	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy. Molecular Imaging and Radionuclide Therapy. 2011; 20(2): 38 - 44.
IEEE	ÖZÜLKER T,Ozulker F,DERİN E,Altun M,Aydogan M,Türkkan E,adaş m,TONBUL M,ÖZPAÇACI T,sezgin f,DEĞİRMENCİ H "The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy." Molecular Imaging and Radionuclide Therapy, 20, ss.38 - 44, 2011.
ISNAD	ÖZÜLKER, TAMER vd. "The efficacy of magnetic resonance imaging and x-ray in the evaluation of response to radiosynovectomy in patients with hemophilic arthropathy". Molecular Imaging and Radionuclide Therapy 20/2 (2011), 38-44.