Zhang Haiyang, Jiang Mengda, Liu Yuting, Lee Xin Ning, Fang Zilin, Li Jipeng, Li Yinwei, Sun Jing, Tao Xiaofeng, Song Xuefei, Zhou Huifang, Fan Xianqun
State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
J Inflamm Res. 2025 Aug 4;18:10489-10498. doi: 10.2147/JIR.S532401. eCollection 2025.
To investigate the alterations in the glymphatic system in patients with thyroid eye disease (TED) using diffusion tensor imaging (DTI) analysis along the perivascular space (ALPS) and to explore the correlation between the glymphatic system and clinical features of TED.
The study included 47 patients with TED, including 20 active TED patients (AP) and 27 inactive TED patients (IP), along with 24 healthy controls (HC). Imaging data including DTI sequence were acquired using a 3.0 Tesla scanner. ALPS values were calculated based on the diffusivity of the bilateral superior corona radiata and superior longitudinal fasciculus. Correlation analysis were thus performed between ALPS values and clinical characteristics.
The DTI-ALPS analysis in the TED patient group collectively showed lower mean and left ALPS values compared to the HC, with statistically significant differences observed (mean ALPS: P=0.0308, left ALPS: P=0.0032). Among the TED subgroups, the IP had significantly lower left ALPS values than HC (P=0.006). Correlation analysis within the IP subgroup indicated that lower ALPS values were significantly associated with longer disease duration (P=0.015) and greater palpebral fissure height (P=0.028).
Glymphatic system dysfunction is evident in TED patients, with its extent influenced by disease activity and duration.
利用沿血管周围间隙（ALPS）的扩散张量成像（DTI）分析，研究甲状腺眼病（TED）患者淋巴系统的改变，并探讨淋巴系统与TED临床特征之间的相关性。
该研究纳入了47例TED患者，包括20例活动期TED患者（AP）和27例非活动期TED患者（IP），以及24例健康对照者（HC）。使用3.0特斯拉扫描仪获取包括DTI序列在内的成像数据。基于双侧放射冠上部和上纵束的扩散率计算ALPS值。因此，对ALPS值与临床特征进行了相关性分析。
与HC相比，TED患者组的DTI-ALPS分析总体显示平均和左侧ALPS值较低，差异有统计学意义（平均ALPS：P = 0.0308，左侧ALPS：P = 0.0032）。在TED亚组中，IP的左侧ALPS值显著低于HC（P = 0.006）。IP亚组内的相关性分析表明，较低的ALPS值与病程较长（P = 0.015）和睑裂高度较大（P = 0.028）显著相关。
TED患者存在明显的淋巴系统功能障碍，其程度受疾病活动度和病程的影响。
