基于MRI探索甲状腺相关性眼病眶内组织与复视的相关性  

Relationship between orbital tissues and diplopia in thyroid-associated ophthalmopathy based on MRI

作　　者：石桂凤 段勇波 黄凯 刘丹 陈海雄 SHI Guifeng;DUAN Yongbo;HUANG Kai;LIU Dan;CHEN Haixiong(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510000,China;Department of Radiology,Shunde Hospital of Southern Medical University(First People's Hospital of Shunde District,Foshan City),FoShan 528300,China;Department of Ophthalmology,Shunde Hospital of Southern Medical University(First People's Hospital of Shunde District,Foshan City),Foshan 528300,China)

机构地区：[1]南方医科大学第二临床医学院,广州510000 [2]南方医科大学顺德医院(佛山市顺德区第一人民医院)放射科,佛山528300 [3]南方医科大学顺德医院(佛山市顺德区第一人民医院)眼科,佛山528300

出　　处：《磁共振成像》2024年第9期53-59,67,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：广东省医学科学技术研究基金项目(编号:B2022185);佛山市自筹经费类科技计划项目(编号:2220001003987);南方医科大学顺德医院院内科研启动计划项目(重点专科-培育项目)(编号:SRSP2021037)。

摘　　要：目的利用MRI技术探讨甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)患者眼外肌、眶内脂肪与TAO复视的相关性。材料与方法研究对象包含TAO复视组(79例,157只眼)、TAO非复视组(36例,72只眼)及正常对照组(30例,60只眼)。测量眼外肌厚度、眼外肌体积(extraocular muscle volume,EMV)、眼外肌与白质信号强度比(signal intensity ratio,SIR)、眶内脂肪体积(fat volume,FV)、眼眶体积(orbital volume,OV),并收集患者临床及实验室资料,包括年龄、性别、吸烟史、促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、甲状腺球蛋白(thyreoglobulin,TG)、甲状腺素受体抗体(thyrotropin receptor antibody,TRAb)、抗甲状腺球蛋白抗体(anti-thyroglobulin antibody,anti-TGAb)、抗甲状腺过氧化物酶自身抗体(anti-thyroid peroxidase utoantibody,anti-TPOAb)。通过单因素方差分析、Mann-Whitney U检验、Kruskal-Wallis H检验及卡方检验比较三组的基线资料、临床指标和影像学参数。再通过单因素及多因素logistic回归分析TAO复视的独立危险因素,并绘制受试者工作特征(receiver operating characteristics,ROC)曲线评估危险因素的诊断价值。结果TAO复视组、TAO非复视组和正常对照组在年龄、上直肌厚度(superior rectus thickness,SR-T)、下直肌厚度(inferior rectus thickness,IR-T)、内直肌厚度(medial rectus thickness,MR-T)、外直肌厚度(lateral rectus thickness,LR-T)、EMV、FV/OV、SIRmean、SIRmax的差异有统计学意义(P<0.05);TAO复视组与TAO非复视组在IR-T、MR-T、FV/OV、EMV、SIRmax的分布差异有统计学意义(P<0.05),在SR-T、LR-T、SIRmean的差异无统计学意义(P>0.05);TAO复视与TAO非复视在TSH与TRAb的差异也有统计学意义(P<0.05)。单因素和多因素logistic回归分析表明,TRAb、FV/OV、EMV是TAO复视的独立危险因素,并绘制ROC曲线,分析单独及联合指标对TAObjective:To explore the correlation between extraocular muscles,orbital fat,and thyroid-associated ophthalmopathy(TAO)diplopia using MRI technology.Materials and Methods:The subjects of the study included the TAO diplopia group(79 cases,157 eyes),the TAO non-diplopia group(36 cases,72 eyes)and the normal control group(30 cases,60 eyes).The extraocular muscle thickness,extraocular muscle volume(EMV),extraocular muscle-to-white matter signal intensity ratio(SIR),intraorbital fat volume(FV),and orbital volume(OV)of the study subjects were measured,and clinical and laboratory data were collected,including age,gender,smoking history,thyroid-stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroglobulin(TG),thyroxine receptor antibody(TRAb),anti-thyroglobulin antibody(anti-TGAb)and anti-thyroid peroxidase utoantibody(anti-TPOAb).One-way analysis of variance,Mann-Whitney U test,Kruskal-Wallis H test and chi-square test were used to compare the baseline data,clinical indicators and imaging parameters of the three groups.Then univariate and multivariate logistic regression analysis were used to analyze the independent risk factors of TAO diplopia,and the receiver operating characteristics(ROC)curves were plotted to evaluate the diagnostic value of risk factors.Results:There were statistically significant differences in age,superior rectus thickness(SR-T),inferior rectus thickness(IR-T),medial rectus thickness(MR-T),lateral rectus thickness(LR-T),EMV,FV/OV,SIRmean,and SIRmax between TAO diplopia,TAO non-diplopia,and normal control groups(P<0.05).There were statistically significant differences in the distribution of IR-T,MR-T,FV/OV,EMV,and SIRmax between TAO diplopia and TAO non-diplopia(P<0.05).There was no statistically significant difference in SR-T,LR-T,and SIRmean(P>0.05),and there was also a statistically significant difference between TAO diplopia and TAO non-diplopia in TSH and TRAb(P<0.05).Univariate and multivariate logistic regression analysis showed that TRAb,FV/OV and EMV were independe

关 键 词：甲状腺相关性眼病 复视 眼外肌 脂肪体积 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R581.1[医药卫生—诊断学] R771.3[医药卫生—临床医学]