Application of Multiparameter Quantitative Magnetic Resonance Imaging in the Evaluation of Graves' Ophthalmopathy

Abstract

BackgroundAssessment of the activity of Graves' ophthalmopathy (GO) is difficult. Existing methods need improvement.PurposeInvestigate the application of multiparametric magnetic resonance imaging (MRI) in GO.Study TypeRetrospective.PopulationA total of 235 GO patients (age: 38.8 ± 13.4 years; 90 male; 96 active patients).Field Strength/SequenceShort‐tau inversion recovery (STIR) fast spin echo, multiecho spin echo T2 mapping and 3D T1‐weighted fast field echo sequences at 3.0 T.AssessmentTwo physicians assessed the mean and maximum signal intensity ratio of extraocular muscles to white matter (SIR), T2 relaxation time (T2RT), extraocular muscle area (EMA), fat fraction (FF), retrobulbar fat volume (RFV), and extraocular muscle volume (EMV). Clinical activity score (CAS) ≧ 3 was in active stage.Statistical TestsThe optimal cut‐off point of diagnostic efficacy was selected using receiver operating characteristic (ROC) curve analysis and evaluated using area under the curve (AUC), compared using Student's t test, analysis of variance or Kruskal–Wallis H test. The correlation used Pearson correlation analysis. The discriminant equation used a binary logistic regression analysis. P < 0.05 was considered statistically significant.ResultsThe SIRmean, SIRmax, T2RTmean, T2RTmax, EMA, and EMV in active GO patients were significantly higher than those in inactive and were positively correlated with CAS (r = 0.276, 0.228, 0.438, 0.388, 0.502, and 0333, respectively). The FFmax of active patients was significantly lower than that of inactive patients and was negatively correlated with CAS (r = −0.44). Logistic regression analysis indicated that T2RTmean was independently associated with GO active periods and had good diagnostic performance (area under ROC curve = 0.736, sensitivity 70.7%, specificity 69.3%). T2RTmean ≧ 74.295 could be a diagnostic cut‐off for judging GO activity (sensitivity 55.3%).ConclusionSIR, T2RT, EMV, and FF can quantitatively assess the activity and severity of GO and can potentially provide a basis for clinical judgment and selection of treatment options.Evidence Level4.Technical EfficacyStage 2.

Dixon MRI-based quantitative parameters of extraocular muscles, intraorbital fat, and lacrimal glands for staging thyroid-associated ophthalmopathy

“…The involvement of EOMs is a known disease process in patients with TAO [ 16 , 17 ]. In this study, we found that the SIR min/mean/max values of EOMs were significantly greater in active TAOs than those in inactive TAOs, consistent with previous studies [ 18 , 19 ]. In addition, using the Dixon MRI technique, our study indicated that active TAOs had higher water-related metrics (EOM-WF mean and EOM-WF min ) and lower fat-related parameters (EOM-FF max and EOM-FF mean ) than did inactive TAOs.…”

Assessing the relationship between levator palpebrae superioris and thyroid-associated ophthalmopathy using the Dixon-T2WI sequence

“…The signal intensity in ipsilateral brain white matter regions of interest was measured three times on coronal water-phase Dixon-T2WI images showing the maximum white matter area of each brain, and an average was taken ( Figure 1C ). The ratio of the maximum signal intensity of LPS to the mean signal intensity of brain white matter (LPS_SIR) was calculated ( 27 , 28 ).…”