Evaluation of Lacrimal Gland Function in Sjogren Syndrome with Dynamic MR Dacryocystography after Injection of Antirex

本研究旨在探讨动态泪道磁共振成像在评价注射安替瑞克斯后泪腺导管行为及评价干燥综合征患者泪腺功能方面的应用价值。动态MR泪道成像采用单次激发稀有序列，表面线圈直径为4 cm。成像参数：回声间隔=11.5毫秒，有效TE=1100毫秒，ETL=240，层厚=30 mm，FOV=169×169 mm，图像矩阵=240×256，面内分辨率=0.70×0.66 mm，NEX=1，采集时间=7.1秒。静脉注射安替瑞克斯后，立即进行顺序性MR泪道造影。8名对照受试者和48名疑似干燥综合征伴干眼症状的患者被纳入本研究。所有患者均行唇腺活检和Schirmer‘s试验。对动态MR泪道成像进行形态和功能评价，并与唇腺活检和Schirmer‘s试验结果进行对比研究。对照组注射安泰后不久即可见泪囊，此后鼻泪管逐渐显影。在怀疑患有干燥综合征的患者中，泪囊和鼻泪管的动态MR泪道成像显示延迟或缺失。动态泪道磁共振检查结果与Schirmer试验结果有显著相关性(p&lt；.001)。动态泪道MR检查结果与唇腺活检结果有相关性(p&lt；.01)。我们的结论是，注射安替瑞克斯后的动态MR泪道成像为干燥综合征患者的泪腺状况提供了详细的生理信息。

This study was conducted to assess the utility of dynamic MR dacryocystography in the evaluation of the behavior of the lacrimal gland duct after injection of Antirex (edrophonium chloride), and to estimate the lacrimal gland function in patients with Sjogren syndrome. Dynamic MR dacryocystography was obtained using a single-shot RARE sequence with a 4-cm-diameter surface coil. Imaging parameters were : echo spacing=11.5 msec, effective TE=1100 msec, ETL=240, slab thickness=30 mm, FOV=169X169 mm, image matrix=240X256, in-plane resolution=0.70X0.66 mm, NEX=1, acquisition time=7.1 sec. Immediately after intravenous injection of Antirex, sequential MR dacryocystograms were obtained. Eight control subjects and 48 patients suspected of having Sjogren syndrome with symptoms of dry eye were included in this study. Labial gland biopsy and Schirmer's test were performed in all patients. Morphologic and functional evaluation of dynamic MR dacryocystography was performed and comparative study with the results of labial gland biopsy and Schirmer's test was done. In control subjects, the lacrimal sac was seen soon after the injection of Antirex, thereafter the nasolacrimal duct was gradually demonstrated. In patients suspected of having Sjogren syndrome, delayed or lack visualization of lacrimal sac and nasolacrimal duct was seen on dynamic MR dacryocystography. Significant correlation was present between the results of dynamic MR dacryocystography and Schirmer's test (p<.001). Also there was correlation between the results of dynamic MR dacryocystography and labial gland biopsy (p<.01). We conclude that dynamic MR dacryocystography after injection of Antirex provides detailed, physiologic information about the conditions of lacrimal gland in patients with Sjogren syndrome.