Multiparametric quantitative MRI for the evaluation of dysthyroid optic neuropathy

Zou, Mengsha; Wu, Dide; Zhu, Huilian; Huang, Xia-Hua; Zhao, Xiaojuan; Zhao, Jing; Fu, Wenhao; Li, Ruocheng; Li, Bin; Park, Wan; Hong, Shubin; Li, Yanbing; Xiao, Hang; Yang, Zhiyun

doi:10.1007/s00330-021-08300-2

Cited by 17 publications

(15 citation statements)

References 28 publications

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“…Although MRI is also used for imaging diagnostics today, CT continues to be frequently used as the preferred technique since both the bony orbit and intraorbital structures are excellently visualized [ 1 , 6 , 17 ]. Volumetric analysis of (intra-)orbital structures has been established on the basis of both CT and MR images with comparable results [ 8 , 14 , 18 , 19 , 20 ]. In addition to fully manual segmentation (planimetry), the semi-automatic technique (with the possibility of manual adjustment) has also proven successful for volumetric analysis [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Increased Orbital Muscle Fraction Diagnosed by Semi-Automatic Volumetry: A Risk Factor for Severe Visual Impairment with Excellent Response to Surgical Decompression in Graves’ Orbitopathy

Steiert

Kuechlin

Masalha

et al. 2022

JPM

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Graves’ orbitopathy (GO) leads to increased orbital tissue and causes symptoms such as exophthalmos, functional complaints, or dysthyroid optic neuropathy. Different GO types with fat and/or muscle enlargement were identified, and increased muscle appears to particularly influence visual status and treatment response. The current study examines visual parameters dependent on orbital muscle volume fraction in a surgically treated GO cohort. After volumetric analysis of the preoperative orbital content, 83 orbits in 47 patients were categorized into predefined groups (increased or not-increased muscle fraction). All cases underwent pterional orbital decompression, and pre- and postoperative visual status was retrospectively analyzed. Forty-one orbits revealed increased and 42 orbits revealed not-increased muscle volume (mean fraction 29.63% versus (vs.) 15.60%). The preoperative visual acuity (VA) was significantly lower in orbits with increased vs. not-increased muscle volume (mean VA 0.30 vs. 0.53, difference 2.5 lines). After surgery, mean VA improved significantly by 1.7 lines in orbits with increased muscle volume. Not preoperative, but postoperative exophthalmos was significantly lower in orbits with not-increased muscle volume. Increased orbital muscle is associated with significantly reduced VA, but can be remarkably improved by pterional orbital decompression. Therefore, surgical therapy should be considered particularly in decreased VA with orbital muscle enlargement.

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Section: Discussionmentioning

confidence: 99%

“…Increased orbital apex crowding has been found to be associated with DON, but overall increased orbital muscle volume does not seem to necessarily be related to DON [ 5 , 6 , 12 , 13 ]. However, orbital muscle volume appears to be of central importance, and respective studies have focused on predictors of DON [ 12 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Increased Orbital Muscle Fraction Diagnosed by Semi-Automatic Volumetry: A Risk Factor for Severe Visual Impairment with Excellent Response to Surgical Decompression in Graves’ Orbitopathy

Steiert

Kuechlin

Masalha

et al. 2022

JPM

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show abstract

“…Zou and colleagues modified the Barrett index by using Dixon-T2WI with higher resolution, and they calculated the index at four slices behind the eyeball. Muscle index at 21 mm combined with T2 mapping, which could indicate the rupture of the optic nerve myelin sheath and edema, improved the accuracy of diagnosis ( 33 ). On the other hand, the optic nerve subarachnoid space will increase with the edema of the optic nerve in DON.…”

Section: Mri For Evaluation Of Gomentioning

confidence: 99%

Current insights of applying MRI in Graves’ ophthalmopathy

Song

Luo

et al. 2022

Front. Endocrinol.

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Graves’ ophthalmopathy (GO) is an autoimmune disease related to Grave’s disease (GD). The therapeutic strategies for GO patients are based on precise assessment of the activity and severity of the disease. However, the current assessment systems require development to accommodate updates in treatment protocols. As an important adjunct examination, magnetic resonance imaging (MRI) can help physicians evaluate GO more accurately. With the continuous updating of MRI technology and the deepening understanding of GO, the assessment of this disease by MRI has gone through a stage from qualitative to precise quantification, making it possible for clinicians to monitor the microstructural changes behind the eyeball and better integrate clinical manifestations with pathology. In this review, we use orbital structures as a classification to combine pathological changes with MRI features. We also review some MRI techniques applied to GO clinical practice, such as disease classification and regions of interest selection.

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“…Barrett et al ( 4 ) suggested that imaging is particularly important for the evaluation of DON. MRI metrics, including the presence of fluid in the optic nerve sheath, muscle index, optic nerve diameter, optic nerve stretching, or apical crowding, have been previously used to detect DON ( 5 – 8 ). However, most of these methods were indirect manners and provided relatively little direct information about the pathological changes of the optic nerve in DON.…”

Section: Introductionmentioning

confidence: 99%

Multi-Parametric Diffusion Tensor Imaging of The Optic Nerve for Detection of Dysthyroid Optic Neuropathy in Patients With Thyroid-Associated Ophthalmopathy

et al. 2022

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ObjectiveTo evaluate the microstructural changes of the orbital optic nerve in thyroid-associated ophthalmopathy (TAO) patients with or without dysthyroid optic neuropathy (DON) using diffusion tensor imaging (DTI) and investigate whether DTI can be used to detect DON.Materials and Methods59 bilateral TAO patients with (n= 23) and without DON (non-DON, n= 36) who underwent pretreatment DTI were included and 118 orbits were analyzed. The clinical features of all patients were collected. DTI parameters, including mean, axial, and radial diffusivity (MD, AD, and RD, respectively) and fractional anisotropy (FA) of the intra-orbital optic nerve for each orbit were calculated and compared between the DON and non-DON groups. ROC curves were generated to evaluate the diagnostic performance of single or combined DTI parameters. Correlations between DTI parameters and ophthalmological characteristics were analyzed using correlation analysis.ResultsCompared with non-DON, the DON group showed decreased FA and increased MD, RD, and AD (P < 0.01). In the differentiation of DON from non-DON, the MD was optimal individually, and the combination of the four parameters had the best diagnostic performance. There were significant correlations between the optic nerve’s four DTI metrics and the visual acuity and clinical active score (P < 0.05). In addition, optic nerve FA was significantly associated with the amplitude of visual evoked potentials (P = 0.022).ConclusionsDTI is a promising technique in assessing microstructural changes of optic nerve in patients with DON, and it facilitates differentiation of DON from non-DON eyes in patients with TAO.

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Multiparametric quantitative MRI for the evaluation of dysthyroid optic neuropathy

Cited by 17 publications

References 28 publications

Increased Orbital Muscle Fraction Diagnosed by Semi-Automatic Volumetry: A Risk Factor for Severe Visual Impairment with Excellent Response to Surgical Decompression in Graves’ Orbitopathy

Increased Orbital Muscle Fraction Diagnosed by Semi-Automatic Volumetry: A Risk Factor for Severe Visual Impairment with Excellent Response to Surgical Decompression in Graves’ Orbitopathy

Current insights of applying MRI in Graves’ ophthalmopathy

Multi-Parametric Diffusion Tensor Imaging of The Optic Nerve for Detection of Dysthyroid Optic Neuropathy in Patients With Thyroid-Associated Ophthalmopathy

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