The diagnostic value of the IDEAL-T2WI sequence in dysthyroid optic neuropathy: a quantitative analysis of the optic nerve and cerebrospinal fluid in the optic nerve sheath
The diagnostic value of the IDEAL-T2WI sequence in dysthyroid optic neuropathy: a quantitative analysis of the optic nerve and cerebrospinal fluid in the optic nerve sheath
复制标题
IDEAL-T2WI序列对甲状腺功能障碍性视神经病变的诊断价值：视神经及视神经鞘内脑脊液的定量分析
DOI：
10.1007/s00330-021-08030-5
复制
发表时间：
2021-05-15
影响因子：
5.9
通讯作者：
Zhang, Jing
中科院分区：
文献类型：
--
作者：
Wu, Hongyu;Luo, Ban;Zhang, Jing
ObjectivesTo评估视神经鞘中视神经和脑脊液作为甲状腺功能异常性视神经病变（DON）的影像学标志物的价值。MethodsIn this single center retrospective study，眼眶影像学资料包括30例DON患者（54个眼眶）、30例无DON的甲状腺相关眼病（TAO）患者（60个眼眶）和19例健康对照者（HC; 38个眼眶）。测量并比较视神经及其鞘的直径和横截面积、视神经含水率和视神经鞘内液体的体积。采用相关分析方法对MR参数与临床测量值之间的相关性进行了评估。（眼球后3 mm和6 mm）、视神经蛛网膜下腔（ONSS）（眼球后3 mm和6 mm），DON组视神经鞘膜内液量和蛛网膜下腔液量明显高于TAO组（p< 0.01）和HC组（p< 0.01）。ROC分析显示，眼后3 mm的ONSS（ONSS 3）是DON的可靠预测因子（AUC = 0.957，灵敏度= 0.907，特异性= 0.9）。眼后3 mm视神经水分数（waterfraction 3）特异性最好（0.967）。含水率3、视神经鞘中的液体体积和视神经直径（眼球后3 mm）与临床测量相关（即临床活动评分，平均缺陷，结论视神经水分数增加和ONSS 3是诊断DON的有希望和容易获得的放射学标志物。甲状腺功能异常性视神经病变（DON）患者的视神经和视神经蛛网膜下腔（ONSS）的含水量高于甲状腺相关眼病（TAO）患者。视神经和视神经鞘中的脑脊液测量与视觉功能障碍有关。·视神经水分数和ONSS可能是诊断DON的有希望的影像学指标。
ObjectivesTo evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON).MethodsIn this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. The associations between MR parameters and clinical measures were assessed using correlation analysis.ResultsThe diameter and water fraction of the optic nerve (3 mm and 6 mm behind the eyeball), optic nerve subarachnoid space (ONSS) (3 mm and 6 mm behind the eyeball), and subarachnoid fluid volume in the optic nerve sheath were significantly greater in the DON group than in the TAO group (p< 0.01) or HC group (p< 0.01). ROC analysis showed that ONSS 3 mm behind the eyeball (ONSS3) was a robust predictor of DON (AUC = 0.957, sensitivity = 0.907, specificity = 0.9). Water fraction of the optic nerve 3 mm behind the eyeball (water fraction3) had the best specificity (0.967). Water fraction3, fluid volume in the optic nerve sheath, and optic nerve diameter (3 mm behind the eyeball) were correlated with clinical measures (i.e. clinical activity score, mean defect, and pattern standard deviation).ConclusionsIncreased water fraction of the optic nerve and ONSS3 are promising and easily accessible radiological markers for diagnosing DON.Key Points• The water fraction of the optic nerve and optic nerve subarachnoid space (ONSS) are greater in patients with dysthyroid optic neuropathy (DON) than in patients with thyroid-associated ophthalmopathy (TAO) without DON.• The optic nerve and the cerebrospinal fluid in the optic nerve sheath measures are associated with visual dysfunction.• The water fraction of the optic nerve and ONSS may be promising imaging markers for diagnosing DON.