Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou, 510080, China.
Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou, 510080, China.
Eur Radiol. 2022 Mar;32(3):1931-1938. doi: 10.1007/s00330-021-08300-2. Epub 2021 Oct 12.
To evaluate the ability of quantitative MRI parameters for predicting dysthyroid optic neuropathy (DON).
We retrospectively collected and analyzed the clinical features and 3.0 T MRI data of 59 patients with Graves orbitopathy (GO), with (n = 26) and without DON (n = 33). We compared MRI quantitative parameters, including the modified muscle index (mMI), proptosis, volume of intra-orbital fat, mean apparent diffusion coefficient value, and T2 value of the optic nerve among patients with and without DON. A logistic regression analysis was performed to identify the risk factors associated with DON. Moreover, we performed a receiver operating characteristic curve analysis and decision curve analysis to evaluate the diagnostic performance of the identified parameters for DON.
We studied 118 orbits (43 and 75 with and without DON, respectively). The mMI and mean T2 value of the optic nerve were significantly greater in orbits with DON (p < 0.001). A greater mMI at 21 mm (odds ratio (OR), 1.039; 95% confidence interval (CI): 1.019, 1.058) and higher mean T2 value of the optic nerve (OR, 1.035; 95% CI: 1.017, 1.054) were associated with a higher risk of DON. A model combining the mMI at 21 mm and mean T2 values for the optic nerve effectively predicted DON in patients with GO, with a sensitivity and specificity of 95.3% and 76%, respectively.
A quantitative MRI parameter combining the mMI at 21 mm and mean T2 value of the optic nerve can be an effective imaging marker for identifying DON.
• Patients with GO and DON had greater mMI than those without DON. • Optic nerves in patients with DON demonstrated an increased T2 value. • The quantitative MRI parameter combining the mMI at 21 mm and mean T2 value of the optic nerve is the most effective method for diagnosing DON.
评估定量 MRI 参数预测甲状腺相关眼病（DON）的能力。
我们回顾性收集并分析了 59 例格雷夫斯眼病（GO）患者的临床特征和 3.0T MRI 数据，其中有（n=26）和无 DON（n=33）。我们比较了 MRI 定量参数，包括改良肌肉指数（mMI）、眼球突出度、眶内脂肪体积、视神经平均表观扩散系数值和 T2 值，这些参数在有和无 DON 的患者之间进行了比较。进行逻辑回归分析以确定与 DON 相关的危险因素。此外，我们进行了受试者工作特征曲线分析和决策曲线分析，以评估所确定的 DON 诊断参数的诊断性能。
我们研究了 118 只眼眶（43 只和 75 只分别有和无 DON）。有 DON 的眼眶 mMI 和视神经平均 T2 值明显更高（p<0.001）。视神经更大的 mMI（21mm 处，优势比（OR）1.039；95%置信区间（CI）：1.019，1.058）和更高的平均 T2 值（OR，1.035；95%CI：1.017，1.054）与 DON 风险增加相关。结合视神经 21mm 处 mMI 和平均 T2 值的模型可有效预测 GO 患者的 DON，其灵敏度和特异性分别为 95.3%和 76%。
结合视神经 21mm 处 mMI 和平均 T2 值的定量 MRI 参数可作为识别 DON 的有效影像学标志物。
有 DON 的 GO 患者的 mMI 大于无 DON 的患者。
DON 患者的视神经 T2 值增加。
结合视神经 21mm 处 mMI 和平均 T2 值的定量 MRI 参数是诊断 DON 的最有效方法。
