弥漫性甲状腺肿伴甲亢眼病MRI影像学参数及与眼肌活动性的关系  

Correlation between MRI Parameters and Activity of Patients with Graves Ophthalmopathy

作　　者：苏露艳 王砚新 郭琳琪 SU Lu-yan;WANG Yan-xin;GUO Lin-qi(Xing'an League People's Hospital of Ulanhot,Xing'an League,Inner MongoliaHospital Ophthalmology Department,Ulanhot 137400,Inner Mongolia,China;Department of Ophthalmology,Jixi Jikuang Hospital,Jixi 258100,Heilongjiang Province,China;Dalian Hospital of Shengjing Hospital Affiliated to China Medical UniversityBranch,Dalian 116000,Liaoning Province,China)

机构地区：[1]内蒙古兴安盟乌兰浩特市兴安盟人民医院眼科,内蒙古乌兰浩特137400 [2]黑龙江省鸡西市鸡矿医院眼科,黑龙江鸡西258100 [3]中国医科大学附属盛京医院大连医院眼科,辽宁大连116000

出　　处：《中国CT和MRI杂志》2022年第11期52-54,共3页Chinese Journal of CT and MRI

摘　　要：目的分析弥漫性甲状腺肿伴甲亢眼病患者磁共振成像(MRI)影像学参数及与眼肌活动性的关系。方法前瞻性选择2018年1月至2018年12月我院收治的98例弥漫性甲状腺肿伴甲亢眼病患者,根据其临床活动度评分(CAS)评分分为CAS﹤3分组(n=30)与CAS≥3分组(n=68),另收集同期在我院体检的50例健康志愿者为对照组,三组均采用Signa HDXT 3.0 T MRI扫描仪行眼眶自旋回波MRI T_(2)弛豫时间图(T_(2) mapping)成像检查,分析三组眼外肌MRI T_(2) mapping成像特点,比较三组眼外肌MRI T_(2)值,采用spearman相关分析眼外肌MRI T_(2)值与弥漫性甲状腺肿伴甲亢眼病患者眼肌活动性的相关性,采用受试者工作特征曲线(ROC)分析眼外肌MRI T_(2)值对弥漫性甲状腺肿伴甲亢眼病患者眼肌活动性的预测价值。结果CAS≥3分组和CAS﹤3分组双侧上直肌、下直肌、内直肌、外直肌、上斜肌MRI T_(2)值显著高于对照组(P﹤0.05);CAS≥3分组双侧上直肌、下直肌、内直肌、外直肌、上斜肌MRI T_(2)值显著高于CAS﹤3分组(P﹤0.05)。双侧上直肌、下直肌、内直肌、外直肌、上斜肌MRI T_(2)值均与弥漫性甲状腺肿伴甲亢眼病患者眼肌活动性呈正相关(P﹤0.05)。所有眼外肌MRI T_(2)值联合预测弥漫性甲状腺肿伴甲亢眼病患者眼肌活动性的AUC为0.747,95%CI为0.623~0.870,敏感度为73.30%,特异度为80.00%,准确度为75.54%。结论弥漫性甲状腺肿伴甲亢眼病患者眼外肌MRI T_(2)值与眼肌活动性具有明显相关性,眼外肌MRI T_(2)值预测弥漫性甲状腺肿伴甲亢眼病患者眼肌活动性准确性较高,有助于临床治疗方案的选择。Objective To investigate the correlation between magnetic resonance imaging(MRI)parameters and activity of patients with Graves ophthalmopathy.Methods 98 patients with Graves ophthalmopathy in our hospital from January 2018 to December 2018 were enrolled,and divided into two groups according to Clinical Active Score(CAS),CAS﹤3 group(n=30)and CAS≥3 group(n=68),meanwhile,another 50 healthy individuals were set as control group.All selected subjects underwent coronal T_(2)mapping MRI,and the characteristics of the results was analyzed.T_(2) values were compared among three groups.Correlation of T_(2) value and Graves ophthalmopathy activity was analyzed by spearman correlation analysis.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of the extraocular muscle T_(2) value for Graves ophthalmopathy activity.Results Among three groups,the T_(2) values of superior rectus muscle,inferior rectus muscle,medial rectus muscle,external rectus muscle and superior oblique muscle were the highest in CAS≥3 group,followed by CAS﹤3 group and control group(P﹤0.05).T_(2) values of superior rectus muscle,inferior rectus muscle,medial rectus muscle,external rectus muscle and superior oblique muscle were positively correlated with Graves ophthalmopathy activity(P﹤0.05).The AUC,95%CI,sensitivity,specificity and accuracy of T_(2) values of extraocular muscles for Graves ophthalmopathy activity were 73.30%,80.00%and 75.54%respectively.Conclusion T_(2) values of patients with Graves ophthalmopathy are significantly correlated with the disease activity,and T_(2) mapping MRI has high accuracy in predicting Graves ophthalmopathy activity,which can provide basis for clinical treatment.

关 键 词：弥漫性甲状腺肿伴甲亢眼病 磁共振成像 T2弛豫时间图 眼外肌 临床活动度评分 相关性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.91[医药卫生—诊断学]