Rodríguez-González N, Pérez-Rico C, López-Para Giménez R, Arévalo-Serrano J, Del Amo García B, Calzada Domingo L, Flores Ruiz L, Blanco R
Servicio de Oftalmología, Hospital General Universitario de Guadalajara, Guadalajara.
Arch Soc Esp Oftalmol. 2011 Nov;86(11):351-7. doi: 10.1016/j.oftal.2011.06.010. Epub 2011 Sep 9.
To evaluate the orbital structures and to establish correlations with disease activity and severity in patients with Graves' hyperthyroidism and orbitopathy (GO) using short-tau inversion-recovery (STIR) sequence magnetic resonance imaging (MRI).
Observational, cross-sectional, case-control study. Twenty-eight patients with euthyroid status after treatment and GO (GO group) and 15 control subjects (control group) were included. Patients underwent a complete ophthalmologic examination and were then assessed according to the EUGOGO (European Group on Graves' Orbitopathy) recommendations. Muscle cross-sectional areas, orbital tissue volumes and the signal intensity ratio (SIR) from the most inflamed extraocular muscle were calculated using a STIR-T2 weighted sequence MRI. Correlations between clinical and MRI measurements were analyzed.
Enlargements in the cross-sectional areas and volumes were significant for most EOMs (P<.001), but not for the lateral rectus muscle cross-sectional area. A significant difference in SIR values between patients with GO and control subjects (P<.001) was found. No significant correlations were found between muscle cross-sectional areas, orbital tissue volumes, SIR values and the clinical activity parameters.
Given the small sample size of our study, with the obvious need for larger clinical trials, we were unable to demonstrate that the STIR sequences in MRI are a sensitive tool in assessing patients with longstanding GO in order to detect inflammatory changes and activity follow-up, possibly because it is in inactive phase. Meanwhile, it is still necessary to continue performing a thorough clinical evaluation in the therapeutic management of GO.
使用短反转时间反转恢复（STIR）序列磁共振成像（MRI）评估格雷夫斯甲状腺功能亢进症和眼眶病（GO）患者的眼眶结构，并建立其与疾病活动度和严重程度的相关性。
观察性、横断面、病例对照研究。纳入28例治疗后甲状腺功能正常且患有GO的患者（GO组）和15名对照者（对照组）。患者接受全面的眼科检查，然后根据欧洲格雷夫斯眼眶病研究组（EUGOGO）的建议进行评估。使用STIR-T2加权序列MRI计算肌肉横截面积、眼眶组织体积以及最发炎眼外肌的信号强度比（SIR）。分析临床测量值与MRI测量值之间的相关性。
大多数眼外肌的横截面积和体积均显著增大（P<0.001），但外直肌横截面积未增大。GO患者与对照者之间的SIR值存在显著差异（P<0.001）。未发现肌肉横截面积、眼眶组织体积、SIR值与临床活动参数之间存在显著相关性。
鉴于我们研究的样本量较小，且明显需要进行更大规模的临床试验，我们无法证明MRI中的STIR序列是评估长期GO患者以检测炎症变化和进行活动随访的敏感工具，可能是因为其处于非活动期。同时，在GO的治疗管理中继续进行全面的临床评估仍然很有必要。
