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MRI及影像组学在甲状腺相关性眼病诊断评估中的价值

The Value of MRI and Radiomics for the Diagnostic Evaluation of Thyroid-Associated Ophthalmopathy.

作者信息

Zhou Weiyi, Song Yan, Shi Jufeng, Li Tuo

机构信息

Department of Endocrinology, The Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China.

出版信息

Diagnostics (Basel). 2025 Feb 6;15(3):388. doi: 10.3390/diagnostics15030388.

DOI:10.3390/diagnostics15030388
PMID:39941318
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11817439/
Abstract

Thyroid-associated ophthalmopathy (TAO) is a vision-threatening autoimmune disease that involves the extraocular muscles (EOMs) and periorbital fat. Typical signs of TAO include eyelid recession, proptosis, diplopia, and decreased visual acuity. As a self-limited disease, there is major bipolarity in clinical outcomes in TAO population. The early diagnosis and prediction of these refractory and relapsed patients is essential. Unfortunately, commonly used tools such as CAS/NOSPECTS, are based on clinical symptoms and signs alone, have significant limitations. Some imaging techniques or examinations, such as magnetic resonance imaging (MRI), can be very effective in assisting TAO assessment, from exhaustive whiteboard notes to optimized patient outcomes. Being one of the most commonly used and accurate objective examinations for TAO assessment, MRI boosts no ionizing radiation, high soft tissue contrast, better reflection of tissue water content, and the ability to quantify multiple parameters. In addition, novel MR sequences are becoming increasingly more familiar in TAO and other areas of clinical and scientific research. Moreover, radiomics, a method involving the extraction of a large number of features from medical images through algorithms, is a more recent approach used in the analysis and characterization of TAO data. Thus, this review aims to summarize and compare the value of routine and novel functional MRI sequences and radiomics prediction models in the diagnosis and evaluation of TAO.

摘要

甲状腺相关眼病(TAO)是一种威胁视力的自身免疫性疾病,累及眼外肌(EOMs)和眶周脂肪。TAO的典型体征包括眼睑退缩、眼球突出、复视和视力下降。作为一种自限性疾病,TAO患者的临床结局存在明显的两极分化。对这些难治性和复发性患者进行早期诊断和预测至关重要。不幸的是,常用的工具如CAS/NOSPECTS仅基于临床症状和体征,有显著局限性。一些成像技术或检查,如磁共振成像(MRI),在协助TAO评估方面非常有效,从详尽的白板记录到优化患者结局。作为TAO评估最常用且准确的客观检查之一,MRI无电离辐射、软组织对比度高、能更好地反映组织含水量且具备量化多个参数的能力。此外,新型磁共振序列在TAO及其他临床和科研领域越来越为人所熟知。而且,放射组学是一种通过算法从医学图像中提取大量特征的方法,是最近用于TAO数据分析和特征描述的一种方法。因此,本综述旨在总结和比较常规及新型功能磁共振序列和放射组学预测模型在TAO诊断和评估中的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc5/11817439/4a90abdc6af7/diagnostics-15-00388-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc5/11817439/b61291661238/diagnostics-15-00388-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc5/11817439/4a90abdc6af7/diagnostics-15-00388-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc5/11817439/b61291661238/diagnostics-15-00388-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc5/11817439/4a90abdc6af7/diagnostics-15-00388-g002.jpg

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本文引用的文献

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Korean J Radiol. 2024 Oct;25(10):913-923. doi: 10.3348/kjr.2024.0177.
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Extraocular muscle Diffusion Weighted Imaging as a quantitative metric of posterior orbital involvement in thyroid associated orbitopathy.眼外肌扩散加权成像作为甲状腺相关眼病眼眶后部受累的定量指标。
Insights Imaging. 2024 Aug 1;15(1):183. doi: 10.1186/s13244-024-01757-x.
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Magnetic resonance imaging parameters on lacrimal gland in thyroid eye disease: a systematic review and meta-analysis.
甲状腺眼病泪腺磁共振成像参数:系统评价和荟萃分析。
BMC Ophthalmol. 2023 Aug 8;23(1):347. doi: 10.1186/s12886-023-03008-x.
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Quantitative assessment of extraocular muscles in Graves' ophthalmopathy using T1 mapping.使用T1映射对格雷夫斯眼病的眼外肌进行定量评估。
Eur Radiol. 2023 Dec;33(12):9074-9083. doi: 10.1007/s00330-023-09931-3. Epub 2023 Jul 19.
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Application of Multiparameter Quantitative Magnetic Resonance Imaging in the Evaluation of Graves' Ophthalmopathy.多参数定量磁共振成像在 Graves 眼病评估中的应用。
J Magn Reson Imaging. 2023 Oct;58(4):1279-1289. doi: 10.1002/jmri.28642. Epub 2023 Feb 13.
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Observation study of using a small dose of rituximab treatment for thyroid-associated ophthalmopathy in seven Chinese patients: One pilot study.观察研究:小剂量利妥昔单抗治疗 7 例中国甲状腺相关眼病患者的疗效:一项初步研究。
Front Endocrinol (Lausanne). 2023 Jan 18;13:1079852. doi: 10.3389/fendo.2022.1079852. eCollection 2022.
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