Tang Cheng Yang, Huang Qian, Liang Liang, Zhang Ming Qiao, Zheng Xiao Ya, Long Jian
Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
BMC Endocr Disord. 2024 Dec 24;24(1):276. doi: 10.1186/s12902-024-01818-8.
To evaluate the utility of apparent diffusion coefficient (ADC) values of extraocular muscles (EOMs) in differentiating activity of thyroid eye disease (TED).
Forty-two TED patients who underwent diffusion tensor imaging(DTI) were retrospectively enrolled in this study, including 29 patients in analysis group and 13 patients in validation group. The mean, maximum and minimum ADC value of each EOM were regarded as ADCmean, ADCmax and ADCmin. The difference between ADCmax and ADCmin was regarded as △ADC. The correlations between ADCmean or △ADC of each EOM and clinical activity score (CAS) were assessed.
In analysis group, ADCmean differed between active and inactive eyes and positively correlated with CAS in IR (P < 0.05), not in SR,LR and MR(all p > 0.05). While △ADC differed between two groups and negatively correlated with CAS in all EOMs (all P < 0.05). ADCmean predicted active disease at cut-off value of 1259.3 × 10mms with sensitivity of 66.7% and specificity of 71.4% in IR[area under curve = 0.667, P < 0.05]. △ADC predicted disease activity in all EOMs [area under curve 0.658-0.746,all P < 0.05]. The cut-off values of △ADC were 382, 823,520 and 572 × 10mms with sensitivity of 80.0%, 50.0%, 43.3%, 83.3% and specificity of 67.9%, 85.7%, 89.3%, 60.7% in SR, IR, MR, and LR respectively. There were no significant differences in the predictive efficacy among all cut-off values.
Our results showed that DTI is a valuable tool in the assessment of disease activity of TED. Both ADCmean of IR and △ADC of all four EOMs can be used in discriminating disease activity with the same predictive power.
评估眼外肌（EOMs）的表观扩散系数（ADC）值在鉴别甲状腺眼病（TED）活动度方面的效用。
本研究回顾性纳入了42例行扩散张量成像（DTI）的TED患者，其中分析组29例，验证组13例。将每条EOM的平均、最大和最小ADC值分别视为ADCmean、ADCmax和ADCmin。将ADCmax与ADCmin的差值视为△ADC。评估每条EOM的ADCmean或△ADC与临床活动评分（CAS）之间的相关性。
在分析组中，活动眼和非活动眼的ADCmean存在差异，且在下直肌（IR）中与CAS呈正相关（P<0.05），在上直肌（SR）、外直肌（LR）和内直肌（MR）中则无相关性（所有P>0.05）。而△ADC在两组之间存在差异，且在所有EOM中均与CAS呈负相关（所有P<0.05）。在IR中，ADCmean以1259.3×10⁻³mm²/s的临界值预测活动性疾病，灵敏度为66.7%，特异性为71.4%[曲线下面积=0.667，P<0.05]。△ADC可预测所有EOM的疾病活动度[曲线下面积0.658 - 0.746，所有P<0.05]。SR、IR、MR和LR中△ADC的临界值分别为382、823、520和572×10⁻³mm²/s，灵敏度分别为80.0%、50.0%、43.3%、83.3%，特异性分别为67.9%、85.7%、89.3%、60.7%。所有临界值的预测效能无显著差异。
我们的结果表明，DTI是评估TED疾病活动度的一种有价值的工具。IR的ADCmean和所有四条EOM的△ADC均可用于鉴别疾病活动度，且预测能力相同。
