Application of Multiparameter Quantitative Magnetic Resonance Imaging in the Evaluation of Graves' Ophthalmopathy.
Application of Multiparameter Quantitative Magnetic Resonance Imaging in the Evaluation of Graves' Ophthalmopathy.
复制标题
多参数定量磁共振成像在格雷夫斯眼病评估中的应用。
DOI：
10.1002/jmri.28642
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Shen,Jie
中科院分区：
文献类型：
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作者：
Li,Zhangfang;Luo,Yaosheng;Feng,Xiaoting;Zhang,Qing;Zhong,Qiang;Weng,Chanyan;Chen,Zhi;Shen,Jie
背景评估Graves眼病(GO)的活动性是很困难的。目的探讨多参数磁共振成像在GO中的应用。回顾分析GO患者235例(年龄38.80± 13.4 岁；男性90例；96例活动期患者)。场强/序列短时反转恢复(STIR)快速自旋回波、多回波自旋回波T2成像和3D T1加权快速场回波序列，在3.0 T。评估两位医生评估眼外肌与白质的平均和最大信号强度比(SIR)、T2松弛时间(T2RT)、眼外肌面积、脂肪分数(FF)、球后脂肪体积(RFV)和眼外肌体积(EMV)。≧-3临床活动评分处于活跃期。统计检验采用受试者工作特征曲线分析选择诊断疗效的最佳切割点，并用曲线下面积进行评估，比较采用学生检验、方差分析或Kruskal-Wallis H检验。相关分析采用皮尔逊相关分析。结果活动期GO患者的SIR均值、SIRmax、T2 RTmax、T2RTmax、EMA和 均显著高于静止期GO患者，且与CAS值呈正相关(r分别为0.276、0.228、0.438、0.388、0.502和0333)。活动期患者的FFmax明显低于非活动期患者，且与−呈负相关(r=0.44)。Logistic回归分析显示，T2 RT均值与GO活动期独立相关，具有较好的诊断效果(ROC曲线下面积=0.736，敏感性70.7%，特异性69.3%)。T2RT平均值≧=74.295可作为判断GO活动性的临界值(敏感度为55.3%)。结论SIR、T2RT、EMV、FF可定量评价GO的活动性和严重程度，为临床判断和选择治疗方案提供依据。
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'sttest, 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.