Department of Endoclinology, Noguchi Thyroid Clinic and Hospital Foundation, Oita, Japan.
Endocr J. 2010;57(10):853-61. doi: 10.1507/endocrj.k10e-156. Epub 2010 Aug 19.
The aim of this study was to demonstrate that the addition of orbital magnetic resonance (MR) imaging can provide improvement in sensitivity of detection of active disease and the prediction of the response to intravenous glucocorticoid therapy (ivGC), over clinical activity score (CAS) alone. A prospective case series was studied at our institution. Forty eight patients were examined by CAS and orbital MR imaging. The maximum of T2 relaxation times of extraocular muscles (maxT2RT) and other parameters were evaluated by MR imaging. Thirty five of 48 patients underwent ivGC. Twenty of 35 patients, whose CAS was 2 points or less, were evaluated for the response to ivGC. The correlation between CAS and maxT2RT was evaluated. Differentiation of active and inactive GO was performed by CAS and orbital MR imaging. The response to ivGC was evaluated by CAS, orbital MR imaging and ophthalmic parameters. As a result, CAS and maxT2RT showed significant positive correlation (r=0.58, p<0.0001), and 15 patients were positive by CAS and orbital MR imaging. However, 20 patients were positive by only MR imaging. In those 20 patients, there was significant improvement after ivGC. We concluded that orbital MR imaging combined with CAS could improve the sensitivity of detection of active disease and the prediction of the response to ivGC. In addition, even if only one parameter of CAS is positive, further examination with orbital MR imaging is advised.
本研究旨在证明，与单纯临床活动评分（CAS）相比，眼眶磁共振成像（MR）的加入可以提高对活动性疾病的检测敏感性和预测静脉内糖皮质激素治疗（ivGC）反应的能力。本研究在我们机构进行了前瞻性病例系列研究。48 例患者接受了 CAS 和眼眶 MR 成像检查。通过 MR 成像评估了眼外肌（maxT2RT）最大 T2 弛豫时间和其他参数的最大值。35 例 48 例患者接受了 ivGC。20 例 CAS 为 2 分或更低的患者，对 ivGC 反应进行了评估。评估了 CAS 和 maxT2RT 之间的相关性。通过 CAS 和眼眶 MR 成像对活动性和非活动性 GO 进行了区分。通过 CAS、眼眶 MR 成像和眼科参数评估了 ivGC 的反应。结果，CAS 和 maxT2RT 显示出显著的正相关（r=0.58，p<0.0001），15 例患者的 CAS 和眼眶 MR 成像均为阳性。然而，20 例患者仅通过 MR 成像呈阳性。在这 20 例患者中，ivGC 后有显著改善。我们得出结论，眼眶 MR 成像与 CAS 相结合可以提高对活动性疾病的检测敏感性和预测 ivGC 反应的能力。此外，即使 CAS 的一个参数为阳性，也建议进一步进行眼眶 MR 成像检查。
