Li Defu, Zhu Tingting, Wang Yujin
Department of Radiology, Fuyong People's Hospital of Baoan District, Shenzhen, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Immun Inflamm Dis. 2025 Jan;13(1):e70131. doi: 10.1002/iid3.70131.
This study aimed to evaluate the activity of extraocular muscles (EOMs) in patients with thyroid-associated ophthalmopathy (TAO) using turbo spin echo imaging. By analyzing tissue heterogeneity, apparent diffusion coefficient (ADC) histogram analysis offers enhanced insights into edema within the EOMs.
Eighty-eight patients with TAO were retrospectively evaluated and allocated into active (n = 24, clinical activity score [CAS] ≥ 3) and inactive (n = 64, CAS < 3) groups. The parameter values of the ADC histogram of EOMs were measured; the efficacy of ADC histograms in distinguishing between TAO activity and inactivity was assessed using receiver operating characteristic curves. Multifactorial logistic regression was used to determine active TAO predictors.
The minimum, maximum, median, mean; and 1st, 5th, 10th, 25th, 75th, 90th, 95th, and 99th percentiles of the ADC histograms were higher in patients with active than that in participants with inactive TAO. The area under the curve (AUC) of the 10th percentile of the ADC histogram and the median distinguishing between active and inactive TAOs were both 0.791 (both p < 0.05), and the AUCs of the combined model of age, sex, smoking, and the 10th percentile in the ADC histogram were better than those of their individual models and the combined model of age, sex, and smoking (all p < 0.05). Smoking and male sex, along with the median > 1.26 μm/s, entropy > 4.03, and standard deviation (SD) > 0.4 of the ADC histogram, were significant predictors of TAO activity, with odds ratios of 2.741 and 6.806, 5.070, 2.652, and 2.197, respectively (all p < 0.05).
ADC histograms provide a new method for distinguishing active from inactive TAO, and the 10th percentile enhances the clinical diagnosis of active TAO. In addition to male sex and smoking, an ADC histogram median > 1.26 μm²/s, entropy > 4.03, or SD > 0.4 may also predict active TAO.
本研究旨在利用快速自旋回波成像评估甲状腺相关眼病（TAO）患者眼外肌（EOM）的活动情况。通过分析组织异质性，表观扩散系数（ADC）直方图分析能更深入地了解EOM内的水肿情况。
回顾性评估88例TAO患者，并将其分为活动期（n = 24，临床活动评分[CAS]≥3）和非活动期（n = 64，CAS＜3）两组。测量EOM的ADC直方图参数值；使用受试者工作特征曲线评估ADC直方图区分TAO活动期和非活动期的效能。采用多因素逻辑回归确定活动期TAO的预测因素。
活动期TAO患者的ADC直方图的最小值、最大值、中位数、平均值以及第1、5、10、25、75、90、95和99百分位数均高于非活动期TAO患者。ADC直方图第10百分位数和中位数区分活动期和非活动期TAO的曲线下面积（AUC）均为0.791（均p＜0.05），年龄、性别、吸烟和ADC直方图第10百分位数的联合模型的AUC优于其各自模型以及年龄、性别和吸烟的联合模型（均p＜0.05）。吸烟、男性性别以及ADC直方图中位数＞1.26μm²/s、熵＞4.03和标准差（SD）＞0.4是TAO活动期的显著预测因素，比值比分别为2.741、6.806、5.070、2.652和2.197（均p＜0.05）。
ADC直方图为区分活动期和非活动期TAO提供了一种新方法，第10百分位数提高了活动期TAO的临床诊断能力。除男性性别和吸烟外，ADC直方图中位数＞1.26μm²/s、熵＞4.03或SD＞0.4也可能预测活动期TAO。
