PDF(Pubmed)
Abstract：
OBJECTIVE: To find a correlation between the clinical (vision-inflammation-strabismus-appearance [VISA] score) and radiological (apparent diffusion coefficient [ADC] values) scores for evaluating disease activity in patients with thyroid-associated orbitopathy.
METHODS: A prospective comparative study.
METHODS: Our study was performed for consecutively diagnosed thyroid-associated orbitopathy (TAO) patients. Clinical evaluation included the VISA classification system with the basic thyroid workup. An inflammatory score of <4/8 was considered inactive and ≥4/8 as an active disease. Every included patient underwent a diffusion-weighted magnetic resonance imaging (DW-MRI) scan of the orbits. The orbital parameters evaluated on imaging included the proptosis, thickness, as well as the ADC values of extraocular muscles.
RESULTS: We studied 33 consecutive patients (23 females, 69.7%) with a mean age of 41.8 years. The majority (n = 27, 81.8%) were hyperthyroid, four were hypothyroid, and two were euthyroid. In the VISA classification, nine patients had active TAO (≥4/8 inflammation score), while 24 had inactive disease. There was a positive correlation between the inflammation score and ADC values of medial rectus (MR), inferior rectus (IR) and lateral rectus (LR). We had nine patients with inflammation scores ≥4. With receiver operating characteristic (ROC) curve analysis, we found that the ADC value of IR can predict disease activity with 68% sensitivity and MR-ADC can predict active TAO with 87% sensitivity.
CONCLUSIONS: The ADC parameters of DW-MRI are objective and less operator dependent than the clinical TAO activity scores like VISA classification. A randomized control trial may provide robust data on this correlation.
METHODS: A prospective comparative study.
METHODS: Our study was performed for consecutively diagnosed thyroid-associated orbitopathy (TAO) patients. Clinical evaluation included the VISA classification system with the basic thyroid workup. An inflammatory score of <4/8 was considered inactive and ≥4/8 as an active disease. Every included patient underwent a diffusion-weighted magnetic resonance imaging (DW-MRI) scan of the orbits. The orbital parameters evaluated on imaging included the proptosis, thickness, as well as the ADC values of extraocular muscles.
RESULTS: We studied 33 consecutive patients (23 females, 69.7%) with a mean age of 41.8 years. The majority (n = 27, 81.8%) were hyperthyroid, four were hypothyroid, and two were euthyroid. In the VISA classification, nine patients had active TAO (≥4/8 inflammation score), while 24 had inactive disease. There was a positive correlation between the inflammation score and ADC values of medial rectus (MR), inferior rectus (IR) and lateral rectus (LR). We had nine patients with inflammation scores ≥4. With receiver operating characteristic (ROC) curve analysis, we found that the ADC value of IR can predict disease activity with 68% sensitivity and MR-ADC can predict active TAO with 87% sensitivity.
CONCLUSIONS: The ADC parameters of DW-MRI are objective and less operator dependent than the clinical TAO activity scores like VISA classification. A randomized control trial may provide robust data on this correlation.
摘要：
目的：寻找临床（视力-炎症-斜视-外观[VISA]评分）和放射学（表观扩散系数[ADC]值）评分之间的相关性，以评估甲状腺相关眼病患者的疾病活动。
方法：前瞻性比较研究。
方法：我们的研究是针对连续诊断的甲状腺相关眼眶病（TAO）患者进行的。临床评估包括VISA分类系统和基本甲状腺检查。<4/8的炎症评分被认为是不活跃的，≥4/8作为活动性疾病。每位纳入的患者均接受了轨道的扩散加权磁共振成像（DW-MRI）扫描。成像时评估的轨道参数包括突度，厚度,以及眼外肌的ADC值。
结果：我们研究了33名连续患者（23名女性，69.7％），平均年龄为41.8岁。大多数（n=27，81.8%）是甲状腺功能亢进，四个是甲状腺功能减退，还有两个甲状腺功能正常。在VISA分类中，9例患者有活动性TAO（≥4/8炎症评分），而24人患有非活动性疾病。炎症评分与内侧直肌(MR)ADC值呈正相关,下直肌（IR）和侧直肌（LR）。我们有9名患者的炎症评分≥4。用接收器工作特性(ROC)曲线分析,我们发现，IR的ADC值可以以68％的灵敏度预测疾病活动性，MR-ADC可以以87％的灵敏度预测活动性TAO。
结论：DW-MRI的ADC参数是客观的，与临床TAO活性评分（如VISA分类）相比，对操作者的依赖性较小。随机对照试验可以提供关于这种相关性的可靠数据。
方法：前瞻性比较研究。
方法：我们的研究是针对连续诊断的甲状腺相关眼眶病（TAO）患者进行的。临床评估包括VISA分类系统和基本甲状腺检查。<4/8的炎症评分被认为是不活跃的，≥4/8作为活动性疾病。每位纳入的患者均接受了轨道的扩散加权磁共振成像（DW-MRI）扫描。成像时评估的轨道参数包括突度，厚度,以及眼外肌的ADC值。
结果：我们研究了33名连续患者（23名女性，69.7％），平均年龄为41.8岁。大多数（n=27，81.8%）是甲状腺功能亢进，四个是甲状腺功能减退，还有两个甲状腺功能正常。在VISA分类中，9例患者有活动性TAO（≥4/8炎症评分），而24人患有非活动性疾病。炎症评分与内侧直肌(MR)ADC值呈正相关,下直肌（IR）和侧直肌（LR）。我们有9名患者的炎症评分≥4。用接收器工作特性(ROC)曲线分析,我们发现，IR的ADC值可以以68％的灵敏度预测疾病活动性，MR-ADC可以以87％的灵敏度预测活动性TAO。
结论：DW-MRI的ADC参数是客观的，与临床TAO活性评分（如VISA分类）相比，对操作者的依赖性较小。随机对照试验可以提供关于这种相关性的可靠数据。
