基于MRI的成人突眼度参考范围的建立及在甲状腺眼病患者中MRI与Hertel法测定突眼度的一致性评价  

Establishment of an MRI-based reference intervals for exophthalmometric values in adults and evaluation of consistency between MRI and Hertel method in measuring exophthalmometric values in patients with thyroid eye disease

作　　者：许祖星 薛哲[1] 边祥兵[2] 程愈[1] 李一君[1] 陈康[1] 杜锦[1] 王先令[1] 裴育[1] 臧丽[1] 郭清华[1] 巴建明[1] 谷伟军[1] 窦京涛[1] 王玉林[1] 吕朝晖[1] 母义明[1] Xu Zuxing;Xue Zhe;Bian Xiangbing;Cheng Yu;Li Yijun;Chen Kang;Du Jin;Wang Xianling;Pei Yu;Zang Li;Guo Qinghua;Ba Jianming;Gu Weijun;Dou Jingtao;Wang Yulin;Lyu Zhaohui;Mu Yiming(Department of Endocrinology,the First Medical Center of Chinese PLA General Hospital,Beijing 100039,China;Department of Radiology,the First Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第一医学中心内分泌科,北京100039 [2]解放军总医院第一医学中心放射诊断科,北京100039

出　　处：《中华医学杂志》2025年第13期1017-1022,共6页National Medical Journal of China

摘　　要：目的建立基于MRI测量的成人突眼度参考范围,并分析在甲状腺眼病(TED)患者中MRI与Hertel法测量的突眼度之间的一致性。方法前瞻性纳入2024年4至9月于解放军总医院第一医学中心接受头颅MRI检查的769例就诊者作为参考人群,年龄[M(Q_(1),Q_(3))]为54.0(39.0,64.0)岁,男369例,女400例。应用眼眶MRI轴位T 2加权像序列测量突眼度,用于制定突眼度参考范围。回顾性纳入2013年1月至2024年8月解放军总医院第一医学中心的152例TED患者,年龄(44.6±11.2)岁,男75例,女77例。用于评估MRI和Hertel法测量突眼度的一致性。运用Bland-Altman图分析两种测量方法一致性,计算95%一致性界限(LoA),超出该界限的点数<5%,认为具有较好的一致性。结果参考人群中左眼和右眼的突眼度均为(15.8±2.1)mm,参考范围分别为11.9~20.1和12.0~20.1 mm。Bland-Altman图分析显示,MRI和Hertel法测量的左眼的突眼度差值为0.66(95%LoA:-4.67~5.99)mm,95.4%(145/152)测量数据介于该范围内;右眼的突眼度差值为0.28(95%LoA:-4.79~5.34)mm,94.7%(144/152)测量数据介于该范围内。结论该研究基于MRI建立的成人左眼及右眼突眼度参考范围分别为11.9~20.1和12.0~20.1 mm。在TED患者中,MRI与Hertel法测得的突眼度可能不一致。Objective To establish reference intervals for exophthalmometric values in adults based on MRI method,and to analyze the consistency between exophthalmometric values obtained via MRI and Hertel method in patients with thyroid eye disease(TED).Method A total of 769 patients who underwent head MRI examination at the First Medical Center of the Chinese PLA General Hospital from April to September 2024 were prospectively included as a reference population,with an age[M(Q_(1),Q_(3))]of 54.0(39.0,64.0)years,including 369 males and 400 females.The orbital MRI axial T 2-weighted image sequence was used to measure the exophthalmometric values and to establish the reference intervals.A total of 152 TED patients aged(44.6±11.2)years old,75 males and 77 females,from January 2013 to August 2024 in the First Medical Center of the Chinese PLA General Hospital were retrospectively included.The patients were used to evaluate the consistency of MRI and Hertel methods in measuring exophthalmometric values.Bland-Altman diagram was used to analyze the consistency of the two measurement methods,and the 95%limits of agreement(LoA)was calculated.The number of points exceeding the limit was<5%,which was considered to have a good consistency.Results In the reference population,the exophthalmometric values for the left and right eyes were(15.8±2.1)and(15.8±2.1)mm respeclively,with reference intervals of 11.9-20.1 and 12.0-20.1 mm,respectively.Bland-Altman analysis showed that the difference in exophthalmometric values measured by the MRI and Hertel methods for the left eye was 0.66(95%LoA:-4.67-5.99)mm,with 95.4%(145/152)of the measurements within this range.For the right eye,the difference was 0.28(95%LoA:-4.79-5.34)mm,with 94.7%(144/152)of the measurements within this range.Conclusions In this study,the reference intervals for exophthalmometric values established based on MRI for the left and right eyes of adults were 11.9-20.1 and 12.0-20.1 mm.In TED patients,the exophthalmometric values obtained by MRI and Hertel methods may not be

关 键 词：突眼 磁共振成像 甲状腺眼病 参考范围 横断面研究 

分 类 号：R581[医药卫生—内分泌]