Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Eur Radiol. 2021 Oct;31(10):7419-7428. doi: 10.1007/s00330-021-08030-5. Epub 2021 May 15.
To evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON).
In this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. The associations between MR parameters and clinical measures were assessed using correlation analysis.
The diameter and water fraction of the optic nerve (3 mm and 6 mm behind the eyeball), optic nerve subarachnoid space (ONSS) (3 mm and 6 mm behind the eyeball), and subarachnoid fluid volume in the optic nerve sheath were significantly greater in the DON group than in the TAO group (p < 0.01) or HC group (p < 0.01). ROC analysis showed that ONSS 3 mm behind the eyeball (ONSS3) was a robust predictor of DON (AUC = 0.957, sensitivity = 0.907, specificity = 0.9). Water fraction of the optic nerve 3 mm behind the eyeball (water fraction3) had the best specificity (0.967). Water fraction3, fluid volume in the optic nerve sheath, and optic nerve diameter (3 mm behind the eyeball) were correlated with clinical measures (i.e. clinical activity score, mean defect, and pattern standard deviation).
Increased water fraction of the optic nerve and ONSS3 are promising and easily accessible radiological markers for diagnosing DON.
• The water fraction of the optic nerve and optic nerve subarachnoid space (ONSS) are greater in patients with dysthyroid optic neuropathy (DON) than in patients with thyroid-associated ophthalmopathy (TAO) without DON. • The optic nerve and the cerebrospinal fluid in the optic nerve sheath measures are associated with visual dysfunction. • The water fraction of the optic nerve and ONSS may be promising imaging markers for diagnosing DON.
评估视神经和视神经鞘中的脑脊液作为甲状腺功能亢进性视神经病变（DON）的影像学标志物。
在这项单中心回顾性研究中，分析了 30 例连续的 DON 患者（54 只眼）、30 例无 DON 的甲状腺相关眼病（TAO）患者（60 只眼）和 19 例健康对照者（HC；38 只眼）的眼眶图像。测量并比较视神经和视神经鞘的直径和截面积、视神经水分数以及视神经鞘内液体体积。使用相关分析评估 MR 参数与临床指标之间的关联。
与 TAO 组（p < 0.01）或 HC 组（p < 0.01）相比，DON 组眼球后 3 毫米和 6 毫米处的视神经直径和水分数、视神经蛛网膜下腔（ONSS）（眼球后 3 毫米和 6 毫米处）以及视神经鞘内蛛网膜下腔液体体积明显更大。ROC 分析显示，眼球后 3 毫米处的 ONSS（ONSS3）是 DON 的可靠预测指标（AUC = 0.957，敏感性 = 0.907，特异性 = 0.9）。眼球后 3 毫米处视神经水分数（water fraction3）的特异性最佳（0.967）。water fraction3、视神经鞘内液体体积和视神经直径（眼球后 3 毫米处）与临床指标（即临床活动评分、平均缺损和模式标准差）相关。
视神经水分数增加和 ONSS3 是诊断 DON 的有前途且易于获得的放射学标志物。
与甲状腺相关眼病（TAO）患者（无 DON）相比，甲状腺功能亢进性视神经病变（DON）患者的视神经和视神经鞘中的脑脊液的水分数更高。
视神经和视神经鞘中的脑脊液测量值与视觉功能障碍有关。
视神经水分数和 ONSS 可能是诊断 DON 的有前途的影像学标志物。
