格雷夫斯眼病：10Gy与24Gy照射联合全身皮质类固醇治疗的磁共振成像评估

Graves ophthalmopathy: MR evaluation of 10-Gy versus 24-Gy irradiation combined with systemic corticosteroids.

作者信息

Nakahara H, Noguchi S, Murakami N, Morita M, Tamaru M, Ohnishi T, Hoshi H, Jinnouchi S, Nagamachi S, Futami S

机构信息

Noguchi Thyroid Clinic, Oita, Japan.

出版信息

Radiology. 1995 Sep;196(3):857-62. doi: 10.1148/radiology.196.3.7644656.

DOI:10.1148/radiology.196.3.7644656

PMID:7644656

Abstract

PURPOSE

To establish the most effective radiation dose for treatment of Graves ophthalmopathy (GO).

MATERIALS AND METHODS

A combination of 10 Gy (n = 15) or 24 Gy (n = 16) of radiation and corticosteroids was used to treat 31 patients with GO. Magnetic resonance (MR) images obtained before treatment showed swollen extraocular muscles with prolonged T2 relaxation times in all patients.

RESULTS

Before therapy, T2 relaxation time of extraocular muscle was 79.6 msec (95% confidence interval, 76.3, 82.9) in the 24-Gy group and 77.4 msec (95% confidence interval, 74.6, 80.1) in the 10-Gy group (P = .32). After therapy, T2 relaxation time was 62.8 msec (95% confidence interval, 61.2, 64.4) in the 24-Gy group and 68.9 msec (95% confidence interval, 66.8, 71.1) in the 10-Gy group. In the 24-Gy group, there was a significant decrease in T2 relaxation times (P = .001) and clinical response to initial treatment was better. At 1- and 3-month follow-up, the resistance rate was lower in the 24-Gy group.

CONCLUSION

In treatment of GO, 24 Gy of radiation is a more effective dose than 10 Gy when combined with systemic corticosteroids.

摘要

目的

确定治疗格雷夫斯眼病（GO）的最有效辐射剂量。

材料与方法

采用10 Gy（n = 15）或24 Gy（n = 16）辐射与皮质类固醇联合治疗31例GO患者。治疗前获得的磁共振（MR）图像显示所有患者的眼外肌肿胀，T2弛豫时间延长。

结果

治疗前，24 Gy组眼外肌的T2弛豫时间为79.6毫秒（95%置信区间，76.3, 82.9），10 Gy组为77.4毫秒（95%置信区间，74.6, 80.1）（P = 0.32）。治疗后，24 Gy组的T2弛豫时间为62.8毫秒（95%置信区间，61.2, 64.4），10 Gy组为68.9毫秒（95%置信区间，66.8, 71.1）。在24 Gy组，T2弛豫时间显著缩短（P = 0.001），对初始治疗的临床反应更好。在1个月和3个月的随访中，24 Gy组的抵抗率较低。