采用T2加权快速自旋回波迭代分解水脂分离成像技术对甲状腺相关眼病患者进行眼眶脂肪容积测定及水含量测量
Orbital Fat Volumetry and Water Fraction Measurements Using T2-Weighted FSE-IDEAL Imaging in Patients with Thyroid-Associated Orbitopathy.
作者信息
Kaichi Y, Tanitame K, Itakura H, Ohno H, Yoneda M, Takahashi Y, Akiyama Y, Awai K
机构信息
From the Department of Diagnostic Radiology (Y.K., K.A.), Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Department of Radiology (K.T.), Chugoku Rosai Hospital, Kure, Japan.
出版信息
AJNR Am J Neuroradiol. 2016 Nov;37(11):2123-2128. doi: 10.3174/ajnr.A4859. Epub 2016 Jun 30.
BACKGROUND AND PURPOSE
The quantitative evaluation of orbital fat proliferation and edema and the assessment of extraocular muscles are useful for diagnosing and monitoring thyroid-associated orbitopathy. To evaluate therapy-induced quantitative changes in the orbital fat of patients with thyroid-associated orbitopathy, we performed volumetric and water fraction measurements by using T2-weighted FSE iterative decomposition of water and fat with echo asymmetry and least-squares estimation (FSE-IDEAL) imaging.
MATERIALS AND METHODS
Orbital FSE-IDEAL images of 30 volunteers were acquired twice within 1 week. Nine patients with thyroid-associated orbitopathy underwent FSE-IDEAL imaging before and after methylprednisolone pulse therapy, and the treatment results were assessed by using their pre- and post-methylprednisolone pulse therapy clinical activity scores. We performed volumetric and water fraction measurements of orbital fat by using FSE-IDEAL imaging and evaluated interscan differences in the volunteers. In patients with thyroid-associated orbitopathy, we compared pre- and posttherapy orbital fat measurements and assessed the correlation between the pretherapy values and clinical activity score improvement.
RESULTS
The reproducibility of results obtained by the quantitative evaluation of orbital fat in volunteers was acceptable. After methylprednisolone pulse therapy, the water fraction in the orbital fat of patients with thyroid-associated orbitopathy was significantly decreased ( < .001). There was a significant positive correlation between the pretherapy water fraction and clinical activity score improvement (right, = 0.82; left, = 0.79) and a significant negative correlation between the pretherapy volume and clinical activity score improvement (bilateral, = -0.84).
CONCLUSIONS
Volumetric and water fraction measurements of orbital fat by using FSE-IDEAL imaging are feasible and useful for monitoring the effects of therapy and for predicting the response of patients with thyroid-associated orbitopathy to methylprednisolone pulse therapy.
背景与目的
眼眶脂肪增生和水肿的定量评估以及眼外肌的评估对于甲状腺相关眼病的诊断和监测很有用。为了评估甲状腺相关眼病患者眼眶脂肪治疗引起的定量变化，我们采用具有回波不对称和最小二乘估计的T2加权快速自旋回波水脂迭代分解成像（FSE-IDEAL）进行容积和水分数测量。
材料与方法
30名志愿者的眼眶FSE-IDEAL图像在1周内采集两次。9例甲状腺相关眼病患者在甲泼尼龙脉冲治疗前后接受FSE-IDEAL成像，并根据其甲泼尼龙脉冲治疗前后的临床活动评分评估治疗效果。我们使用FSE-IDEAL成像对眼眶脂肪进行容积和水分数测量，并评估志愿者的扫描间差异。在甲状腺相关眼病患者中，我们比较了治疗前后的眼眶脂肪测量值，并评估了治疗前值与临床活动评分改善之间的相关性。
结果
志愿者眼眶脂肪定量评估结果的可重复性是可接受的。甲泼尼龙脉冲治疗后，甲状腺相关眼病患者眼眶脂肪中的水分数显著降低（<0.001）。治疗前水分数与临床活动评分改善之间存在显著正相关（右侧，=0.8；左侧，=0.79），治疗前体积与临床活动评分改善之间存在显著负相关（双侧，=-0.84）。
结论
使用FSE-IDEAL成像对眼眶脂肪进行容积和水分数测量对于监测治疗效果以及预测甲状腺相关眼病患者对甲泼尼龙脉冲治疗的反应是可行且有用的。
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