Objective To evaluate early cartilage damage of the knee joints in patients with hemophilic arthropathy by shear wave elastography(SWE),and to explore its clinical application value.Methods Twenty-six male hemophilia A patients with recurrent knee bleeding(case group,including 3 mild cases,4 moderate cases,and 19 severe cases)and 30 male healthy volunteers(control group)from our hospital were enrolled.Two-dimensional ultrasound was performed to obtain the thickness of articular cartilage at the medial condyle,femoral inter-condyle,and lateral condyle(d1,d2,d3).The Ultrasound Assessment of the Joint in Hemophilia(HEAD-US-C)of hemophilic arthropathy was used to score.The average Young's modulus(E1,E2,E3)and shear wave velocity(SWV1,SWV2,SWV3)of articular cartilage at the medial condyle,femoral inter-condyle,and lateral condyle were obtained by SWE.Differences of above parameters between the case group and control group,as well as among patients with different degrees of hemophilic arthropathy were compared.The correlation between SWE parameters and HEAD-US-C score were analyzed.Results The d1,d2,d3,E2,E3,SWV2 and SWV3 in the case group were lower than those in the control group(all P＜0.05),there were no significant difference in E1 and SWV1 between the two groups.The E2,E3,SWV2 and SWV3 in the the moderate cases and the severe cases were lower than those in the mild cases(all P＜0.05),while there were no significant difference in these parameters between the moderate cases and the severe cases.The difference of the HEAD-US-C score among the mild,moderate,and severe cases were statistically significant(P=0.004),and the HEAD-US-C score in the moderate and severe cases was significantly higher than that in the mild cases(both P＜0.05).Correlation analysis showed that E1,E2,E3,SWV1,SWV2,SWV3 were negatively correlated with HEAD-US-C score in patients with hemophilic arthropathy(all P＜0.001).Conclusion SWE can quantitatively detect the cartilage stiffness of the knee joint in patients with hemophilic arthropathy and early assess cartilage damage,which has good clinical application value.
NETL
NSTL
万方数据
