Fractional anisotropy and diffusivity changes in thyroid-associated orbitopathy

Han, Ji Sung; Seo, Hyeong-Seok; Lee, Young Hen; Lee, Hwa; Suh, Sang Il; Jeong, Eun Kee; Sapkota, Nabraj; Kim, Ki Joon

doi:10.1007/s00234-016-1764-0

Cited by 23 publications

(29 citation statements)

References 42 publications

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“…A previous study reported that n-ADC of the extra-ocular muscles correlated with CAS and the muscle dysfunction score (p = 0.001) [19]. The radial diffusivity of the medial rectus muscle was significantly higher in patients (p = 0.010) and correlated with the muscle thickness (r = 0.349, p = 0.027) [17]. Another study found that there is no correlation between the ADC values and the CAS at the time of diagnosis [18].…”

Section: Discussionmentioning

confidence: 88%

“…In this work, the ADC value of lacrimal glands in patients with thyroid eye disease is significantly higher (p = 0.001) than that of volunteers. This is explained by excess production of hydrophilic glycosaminoglycan causing retention of the water molecules within the lacrimal glands, and because there is an increase in the diffusion space of water protons in the extracellular and an increase in the intracellular dimensions of the lacrimal glands in thyroid eye disease, which increase the diffusivity of the gland [17][18][19][20][21][22]. Previous studies that applied diffusion-weighted MR imaging of the extra-ocular muscles reported that the ADC values of the extra-ocular muscles, especially the medial and lateral rectus muscle, are significantly higher in patients with thyroid eye disease than in healthy volunteers [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…Another study added that many factors might influence the ADC values within the extra-ocular muscles in thyroid eye disease, including oedema, fibrosis, infiltration of the inflammatory cells, and deposition of glycosaminoglycans [19]. In the acute stage, the diffusivities of the medial rectus muscle increase compared with chronic stage but do not reach a significant level [17].…”

Section: Discussionmentioning

confidence: 99%

“…Diffusion-weighted MR imaging is used for characterisation of orbital [12][13][14] and thyroid lesions [15,16]. Few studies discuss diffusion-weighted and diffusion tensor imaging of the extra-ocular muscles [17][18][19][20] and the optic nerves [21,22] in patients with thyroid eye disease.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Razek¹,

El-Hadidy²,

El-Metwaly³

et al. 2019

Pol J Radiol

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Purpose: To assess the lacrimal glands in patients with thyroid eye disease with diffusion-weighted magnetic resonance (MR) imaging. Material and methods: This study was carried out on 44 consecutive patients (17 males, 27 females, with mean age 36 years) with thyroid eye disease and 20 age-and sex-matched volunteers. They underwent diffusion-weighted MR imaging of the orbit. The apparent diffusion coefficient (ADC) values of the lacrimal glands were calculated and correlated with the clinical activity score (CAS). Results: The mean ADC of lacrimal glands in thyroid eye disease (1.73 × 10-3 mm 2 /s) was significantly higher (p = 0.001) than that of volunteers (1.52 × 10-3 mm 2 /s). The cutoff ADC value of lacrimal gland used for differentiation of thyroid eye disease from volunteers was 1.62 × 10-3 mm 2 /s with an area under the curve value of 0.95 and an accuracy of 96%. There was significant difference (p = 0.03) in the ADC of the lacrimal glands in patients with active (n = 24) and inactive (n = 20) disease. The cutoff ADC value of the lacrimal gland used to suspect active disease was 1.76 × 10-3 mm 2 /s with an area under the curve value of 0.80 and an accuracy of 82%. There was positive correlation between the ADC value of the lacrimal glands and CAS (r = 0.73, p = 0.001). Conclusions: The ADC of the lacrimal glands is a non-invasive imaging parameter that can be used for diagnosis of thyroid eye disease and to predict the active form of the disease.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Razek¹,

El-Hadidy²,

El-Metwaly³

et al. 2019

Pol J Radiol

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“…Diffusion tensor imaging (DTI), which provides quantitative information about the microstructural integrities of highly oriented tissues, has been increasingly applied for assessing various orbital diseases, such as glaucoma, optic neuritis, and others (10)(11)(12)(13). However, studies that apply DTI to assess microstructural changes in TAO patients are still limited (14,15), with only two small sample studies (with 20 TAO cases) focusing on EOMs and optic nerves, respectively. Moreover, in previous studies, single-shot echo-planar imaging (ss-EPI) sequences were commonly used for obtaining orbital DTI (11)(12)(13)(14)(15).…”

Section: Magnetic Resonance Examinationmentioning

confidence: 99%

Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using Readout-Segmented Echo-Planar Imaging-Based Diffusion Tensor Imaging

Chen

et al. 2020

Korean J Radiol

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Objective: We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroidassociated orbitopathy (TAO) as well as in evaluating disease activity. Materials and Methods: We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPIbased DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity. Results: Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%). Conclusion: rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.

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Application of Quantitative MRI in Thyroid Eye Disease: Imaging Techniques and Clinical Practices

Zhang,

Lu,

Liu

et al. 2023

Magnetic Resonance Imaging

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Thyroid eye disease (TED) is a complex autoimmune disorder that impairs various orbital structures, leading to cosmetic damage and vision loss. Magnetic resonance imaging (MRI) is a fundamental diagnostic tool utilized in clinical settings of TED, for its accurate demonstration of orbital lesions and indication of disease conditions. The application of quantitative MRI has brought a new prospect to the management and research of TED, offering more detailed information on morphological and functional changes in the orbit. Therefore, many researchers concentrated on the implementation of different quantitative MRI techniques on TED for the exploration of clinical practices. Despite the abundance of studies utilizing quantitative MRI in TED, there remain considerable barriers and disputes on the best exploitation of this tool. This could possibly be attributed to the complexity of TED and the fast development of MRI techniques. It is necessary that clinical and radiological aspects of quantitative MRI in TED be better integrated into comprehensive insights. Hence, this review traces back 30 years of publications regarding quantitative MRI utilized in TED and elucidates this promising application in the facets of imaging techniques and clinical practices. We believe that a deeper understanding of the application of quantitative MRI in TED will enhance the efficacy of the multidisciplinary management of TED.Level of Evidence2Technical EfficacyStage 3

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Fractional anisotropy and diffusivity changes in thyroid-associated orbitopathy

Abstract: DTI can be used to diagnose TAO with FA and radial diffusivity change in EOM. Diffusivities can be used to differentiate acute and chronic stage of TAO. However, DTI values showed limitation in reflecting TAO activity according to the CAS.

Cited by 23 publications

References 42 publications

Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using Readout-Segmented Echo-Planar Imaging-Based Diffusion Tensor Imaging

Application of Quantitative MRI in Thyroid Eye Disease: Imaging Techniques and Clinical Practices

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