T2 mapping MRI distinguishes hemarthrosis from nonhemorrhagic effusion in hemophilia

In patients with hemophilia, in vivo T2 mapping at 3 T differentiated acute hemarthrosis from nonhemorrhagic joint effusion with 100% sensitivity and 100% specificity using a 361-msec cutoff. The median T2 relaxation time was 185 msec for hemorrhagic versus 523 msec for nonhemor…

• Ex vivo validation demonstrated stable T2 discrimination of blood concentrations as low as 0.39% over 14 days, while T1 mapping was reliable only at blood concentrations above 12.5%.
• The study included 30 male participants (mean age 35 years) and used arthrocentesis- or surgery-based fluid classification as the reference standard, yielding an AUC of 1.00 with no overlap in T2 values between groups at the cutoff.

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