Graves' ophthalmopathy: the role of diffusion-weighted imaging in detecting involvement of extraocular muscles in early period of disease
Graves' ophthalmopathy: the role of diffusion-weighted imaging in detecting involvement of extraocular muscles in early period of disease
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DOI：
10.1259/bjr.20140677
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发表时间：
2015-03-01
影响因子：
2.6
通讯作者：
Tasan, E.
中科院分区：
文献类型：
--
作者：
Kilicarslan, R.;Alkan, A.;Tasan, E.
目的：目的：应用弥散加权成像（DWI）评价Graves眼病（GO）患者眼外肌（EOM）受累情况，探讨其与常规眼眶MRI及表观弥散系数（ADC）值的相关性。用临床活动评分评估患者。所有受试者均接受常规MRI和DWI检查。评价了EOM的参与情况。结果：患者组与对照组眼外肌的平均ADC值差异有统计学意义（P < 0. 05），患者组与对照组的平均ADC值差异有统计学意义（P < 0. 05）。所有眼外肌的ADC值在患者中均较高。MR、SR和LR的ADC值在常规MRI上未受累肌肉与对照之间存在显著差异。两组间ADC值差异无统计学意义，但内、外、上级直肌ADC值均增高。结论：GO患者眼外肌ADC值增高提示眼外肌损伤在常规眼眶MRI检测之前就已开始。常规MRI结合DWI序列将有助于筛选早期治疗最有可能获益的患者。认识进展：本研究有助于MRI结合DWI早期评估GO的受累情况。
Objective: To evaluate involvement of the extraocular muscle (EOM) using diffusion-weighted imaging (DWI), to determine whether there is correlation with conventional orbital MRI and apparent diffusion coefficient (ADC) values in patients with Graves' ophthalmopathy (GO).Methods: 35 patients known clinically with GO and 21 healthy controls were studied. Patients were assessed with clinical activity scores. All subjects underwent conventional MRI and DWI study. Involvement of the EOM was evaluated. The patients were classified as involved or uninvolved on orbital MRI and their ADC values in DWI compared.Results: There was significant difference in the mean ADC value of all the EOMs in patients vs controls. The ADC values of all the EOMs were higher in patients. There were significant differences in ADC values between uninvolved muscles on conventional MRI and controls for the MR, SR and LR. There was no significant difference in ADC value between the two groups when considering the IR. ADC values of medial, lateral and superior rectus muscles were increased.Conclusion: Increased ADC values of the EOM in patients with GO suggest that EOM damage begins at a very early stage before being detected on routine orbital MRI. The routine MRI with DWI sequence will be a useful adjunct in the selection of a group of patients most likely to benefit from early treatment.Advances in knowledge: This study can help to evaluate the involvement of GO in early period with MRI added DWI.