Nianiaris N, Hurwitz J J, Chen J C, Wortzman G
Department of Ophthalmology, Mount Sinai Hospital, Toronto, ON.
Can J Ophthalmol. 1994 Feb;29(1):9-12.
Radiologic examination of patients with severe Graves' disease with possible optic neuropathy has routinely been done with computed tomography (CT). With the more widespread use of magnetic resonance imaging (MRI), its potential use in Graves' disease must be considered. We compared these two imaging techniques for use in severe Graves' orbitopathy. Thirty-nine orbits of 20 consecutive patients with severe Graves' disease (19 with optic neuropathy and 20 without optic neuropathy) were examined clinically. CT and MRI were performed, and the radiologic images were assessed for five measures chosen to illustrate overall muscular changes, tissue plane changes of the orbital apex, optic nerve changes and proptosis. The MR images were significantly more reliable than the CT scans for two measures in particular: degree of fat effacement (a measure of optic nerve compression) and minimal optic nerve index (a measure of optic nerve thickness), both of which involve the orbital apex. We conclude that MRI is a better technique than CT for imaging the apex in Graves' optic neuropathy.
对于可能患有视神经病变的重度格雷夫斯病患者，常规采用计算机断层扫描（CT）进行放射学检查。随着磁共振成像（MRI）的更广泛应用，必须考虑其在格雷夫斯病中的潜在用途。我们比较了这两种成像技术在重度格雷夫斯眼眶病中的应用。对连续20例重度格雷夫斯病患者的39个眼眶（19例伴有视神经病变，20例不伴有视神经病变）进行了临床检查。进行了CT和MRI检查，并对放射学图像进行了五项评估，以说明整体肌肉变化、眶尖组织平面变化、视神经变化和眼球突出。特别是在两项评估中，MR图像比CT扫描明显更可靠：脂肪消失程度（一种视神经压迫的测量方法）和最小视神经指数（一种视神经厚度的测量方法），这两项评估均涉及眶尖。我们得出结论，在格雷夫斯视神经病变中，MRI是比CT更好的眶尖成像技术。
