Graduate School of Bengbu Medical University, Bengbu, China.
Department of Radiology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Korean J Radiol. 2024 Oct;25(10):913-923. doi: 10.3348/kjr.2024.0177.
To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO).
SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation.
Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores ( < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) ( < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs ( < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC: 0.925 vs. 0.779; = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI ( = 0.391, < 0.001) and FOCUS MUSE DWI ( = 0.645, < 0.001).
FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.
前瞻性比较单次激发（SS）回波平面成像（EPI）和视野优化及约束无失真单次复用敏感编码（FOCUS MUSE）在评估甲状腺相关眼病（TAO）中的扩散加权成像（DWI）。
对 39 例 TAO 患者（男 18 例；平均年龄±标准差：48.3±13.3 岁）和 26 例健康对照者（男 9 例；平均年龄±标准差：43.0±18.5 岁）进行 SS EPI 和 FOCUS MUSE DWI。两位放射科医生使用 4 分制 Likert 量表对视觉图像质量进行评分。比较两种 DWI 的图像质量评分、信噪比（SNR）、对比噪声比（CNR）和眼外肌（EOM）的表观扩散系数（ADC）。还评估了 EOM ADC 的差异。使用受试者工作特征曲线评估区分活动性和非活动性 TAO 的性能。使用 Spearman 相关性分析 ADC 与临床活动评分（CAS）的相关性。
与 SS EPI DWI 相比，FOCUS MUSE DWI 显示出更高的图像质量评分（<0.001）、外侧直肌（LRM）和内侧直肌（MRM）的 SNR 和 CNR 更高（<0.05），以及 LRM 和 MRM 的 ADC 无显著差异。活动性 TAO 的 ADC 高于 SS EPI 和 FOCUS MUSE DWI 的非活动性 TAO 和健康对照组（均<0.001）。非活动性 TAO 和健康对照组在两种 DWI 中均无明显 ADC 差异。与 SS EPI DWI 相比，FOCUS MUSE DWI 对区分活动性和非活动性 TAO 的效果更好（AUC：0.925 与 0.779；=0.007）。ADC 与 SS EPI DWI 中的 CAS 呈显著相关性（=0.391，<0.001）和 FOCUS MUSE DWI（=0.645，<0.001）。
FOCUS MUSE DWI 提供了更好的 EOM 图像，并在诊断活动性 TAO 方面优于 SS EPI DWI。FOCUS MUSE 的应用将有助于 TAO 的 DWI 评估。
