Yao Jiaqi, Lu Xinjian, Ma Jingxu, Hao Lu, Liu Ying, Huang Xiaopan, Liu Jun, Tong Boding
Department of Radiology, The Second Affiliated Hospital of Xinjiang Medical University, Ürümqi, China.
Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
Front Neurol. 2025 Jun 27;16:1598510. doi: 10.3389/fneur.2025.1598510. eCollection 2025.
Compared to single-shell diffusion tensor imaging (DTI), free water (FW) and neurite orientation dispersion and density imaging (NODDI) offer a more comprehensive evaluation of microstructural alterations in cerebral white matter (WM), particularly in detecting crossing fibers. However, research utilizing multi-shell diffusion imaging to investigate thyroid-associated ophthalmopathy (TAO) remains limited. This study employs FW and NODDI to investigate microstructural changes in the white matter of the visual pathways in patients with TAO.
Multi-shell diffusion magnetic resonance imaging (dMRI) scans were performed on 45 patients with TAO and 31 age- and sex-matched healthy controls (HC). Tract-based spatial statistics (TBSS) analysis was conducted using eight FW and NODDI-derived metrics to identify group differences in white matter microstructure. Furthermore, correlations between these microstructural changes and clinical measures were examined.
TBSS analysis revealed that, compared to HC, patients with TAO exhibited lower free-water corrected fractional anisotropy (fwFA) and free-water corrected axial diffusivity (fwAD), while free-water corrected mean diffusivity (fwMD), free-water corrected radial diffusivity (fwRD), and orientation dispersion index (ODI) were significantly increased ( < 0.05, FWE). Notably, ODI demonstrated the highest area under the curve (AUC) among these metrics. Furthermore, fwFA, fwAD, fwMD, fwRD, and ODI showed significant correlations with the Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and the Graves' Orbitopathy Quality of Life Questionnaire (GO-QOL2) scores.
This study suggests that abnormalities in the white matter microstructure of TAO patients can be detected through the complementary use of FW and NODDI metrics, and it is revealed that these changes may have an impact on mental health.
与单壳扩散张量成像（DTI）相比，自由水（FW）和神经突方向离散度与密度成像（NODDI）能更全面地评估脑白质（WM）的微观结构改变，尤其是在检测交叉纤维方面。然而，利用多壳扩散成像研究甲状腺相关眼病（TAO）的研究仍然有限。本研究采用FW和NODDI来研究TAO患者视觉通路白质的微观结构变化。
对45例TAO患者和31例年龄及性别匹配的健康对照者（HC）进行多壳扩散磁共振成像（dMRI）扫描。使用基于轨迹的空间统计学（TBSS）分析，采用8个FW和NODDI衍生指标来识别白质微观结构的组间差异。此外，还检查了这些微观结构变化与临床指标之间的相关性。
TBSS分析显示，与HC相比，TAO患者的自由水校正分数各向异性（fwFA）和自由水校正轴向扩散率（fwAD）较低，而自由水校正平均扩散率（fwMD）、自由水校正径向扩散率（fwRD）和方向离散度指数（ODI）显著增加（<0.05，FWE）。值得注意的是，在这些指标中，ODI的曲线下面积（AUC）最高。此外，fwFA、fwAD、fwMD、fwRD和ODI与汉密尔顿焦虑评定量表（HAMA）、汉密尔顿抑郁评定量表（HAMD）以及格雷夫斯眼眶病生活质量问卷（GO-QOL2）评分显著相关。
本研究表明，可以通过联合使用FW和NODDI指标检测TAO患者白质微观结构异常，并且揭示这些变化可能对心理健康有影响。
