Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, PR China.
Acta Radiol. 2022 Sep;63(9):1180-1186. doi: 10.1177/02841851211034042. Epub 2021 Aug 1.
Thyroid-associated ophthalmopathy (TAO) is an autoimmune orbital disease characterized by edema of extraocular muscles (EOMs).
To characterize the inflammation of EOMs in patients with TAO before and after radiation therapy using apparent diffusion coefficient (ADC) and to analyze the correlation between ADC and clinical activity of TAO.
The ADCs of superior rectus (SR), inferior rectus (IR), medial rectus (MR), and lateral rectus (LR) muscles were measured in 52 eyes of 26 patients with TAO before and three months after orbital radiation therapy. In addition, 38 eyes of 20 healthy volunteers were included. The clinical activity score (CAS) was evaluated. The ADC maps were reconstructed and measured on the coronal diffusion-weighted imaging (DWI) sequence and calculated in mm/s.
The mean ADCs of EOMs before treatment were 1.42 ± 0.23 in SR, 1.37 ± 0.23 in IR, 1.41 ± 0.21 in MR, and 1.28 ± 0.25 in LR. The mean ADCs after treatment were 1.27 ± 0.18, 1.22 ± 0.26, 1.30 ± 0.22, and 1.15 ± 0.21, respectively. The ADCs were significantly decreased after treatment (all < 0.001). The ADCs of patients with TAO were significantly higher than those of controls. There was a statistically significant correlation between the mean ADCs and the CAS in each patient with TAO both before and after treatment (before: r = 0.520; < 0.001; after: r = 0.625; < 0.001).
The ADC values of EOMs can be exploited as a quantitative indicator to evaluate the clinical activity and monitor the therapeutic responses of patients with TAO.
甲状腺相关眼病（TAO）是一种自身免疫性眼眶疾病，其特征为眼外肌（EOM）水肿。
使用表观扩散系数（ADC）来描述 TAO 患者接受放射治疗前后 EOM 的炎症，并分析 ADC 与 TAO 临床活动之间的相关性。
对 26 例 TAO 患者 52 只眼，在眼眶放射治疗前及治疗后 3 个月，分别测量上直肌（SR）、下直肌（IR）、内直肌（MR）和外直肌（LR）的 ADC 值。此外，还纳入了 20 例健康志愿者的 38 只眼作为对照。评估临床活动评分（CAS）。在冠状面弥散加权成像（DWI）序列上重建 ADC 图并进行测量，结果以毫米/秒（mm/s）表示。
治疗前 EOM 的平均 ADC 值分别为 SR 为 1.42±0.23、IR 为 1.37±0.23、MR 为 1.41±0.21 和 LR 为 1.28±0.25。治疗后分别为 1.27±0.18、1.22±0.26、1.30±0.22 和 1.15±0.21。治疗后 ADC 值均显著降低（均 < 0.001）。TAO 患者的 ADC 值明显高于对照组。TAO 患者治疗前后的平均 ADC 值与 CAS 之间均存在显著相关性（治疗前：r=0.520； < 0.001；治疗后：r=0.625； < 0.001）。
EOM 的 ADC 值可以作为一种定量指标，用于评估 TAO 患者的临床活动并监测治疗反应。
