甲状腺功能异常性视神经病变的CT扫描证据。
CT scan evidence of dysthyroid optic neuropathy.
作者信息
Giaconi JoAnn A, Kazim Michael, Rho Tae, Pfaff Charles
机构信息
College of Physicians and Surgeons, Columbia University, New York, New York, USA.
出版信息
Ophthalmic Plast Reconstr Surg. 2002 May;18(3):177-82. doi: 10.1097/00002341-200205000-00005.
PURPOSE
To determine the utility of CT imaging in identifying patients with dysthyroid optic neuropathy.
METHODS
Orbital CT scans of 12 randomly selected patients with dysthyroid optic neuropathy and 15 control subjects with Graves orbitopathy were retrospectively reviewed by two investigators blinded to the clinical data. The clinical diagnosis of optic neuropathy was made by one author before obtaining CT images and was based on clinical features.
RESULTS
Optic nerve crowding (P<0.001) and intracranial fat prolapse (P<0.05) were the imaging features independently related to optic neuropathy. A muscle index greater than 50% had excellent sensitivity (100%) but did not have high specificity (47%) for dysthyroid optic neuropathy. Superior ophthalmic vein dilation and proptosis did not show significant relations with optic neuropathy.
CONCLUSIONS
This study suggests that patients with Graves orbitopathy who have severe optic nerve crowding, intracranial fat prolapse, and/or muscle index greater than 50% present on orbital CT scans are more likely to have coexisting optic neuropathy.
目的
确定CT成像在诊断甲状腺功能异常性视神经病变患者中的效用。
方法
两名对临床数据不知情的研究人员对12例随机选取的甲状腺功能异常性视神经病变患者和15例格雷夫斯眼眶病对照受试者的眼眶CT扫描进行回顾性分析。一名作者在获取CT图像之前根据临床特征做出视神经病变的临床诊断。
结果
视神经受压（P<0.001）和颅内脂肪脱垂（P<0.05）是与视神经病变独立相关的影像学特征。肌肉指数大于50%对甲状腺功能异常性视神经病变具有极佳的敏感性（100%），但特异性不高（47%）。眼上静脉扩张和眼球突出与视神经病变无显著相关性。
结论
本研究提示，眼眶CT扫描显示有严重视神经受压、颅内脂肪脱垂和/或肌肉指数大于50%的格雷夫斯眼眶病患者更可能并存视神经病变。
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