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• Clinical Article •
Diagnostic value of quantitative measurement of orbital structure by 3 T MRI in staging of Graves ophthalmopathy
WANG Man  SHEN Zhongyuan  KAN Hong  WU Xingwang 

Cite this article as WANG M, SHEN Z Y, KAN H, et al. Diagnostic value of quantitative measurement of orbital structure by 3 T MRI in staging of Graves ophthalmopathy[J]. Chin J Magn Reson Imaging, 2024, 15(5): 61-67. DOI:10.12015/issn.1674-8034.2024.05.011.


[Abstract] Objective To evaluate the correlation between lacrimal gland parameters and clinical activity score (CAS) in patients with Graves ophthalmopathy (GO) by 3 T MRI.Materials and Methods A total of 40 patients with 80 eyes of diagnosed with GO from Fuyang Hospital Affiliated to Anhui Medical University and the First Affiliated Hospital of Anhui Medical University from February 2020 to June 2023 were prospectively selected as the GO group, and 40 healthy people with 80 eyes matching the gender and age of the GO group were selected as the control group. According to CAS score, GO patients were divided into active GO group and inactive GO group. The conventional MRI images and readout segmentation of long variable echo-trains diffusion weighted images (RESOLVE DWI) were used to collect images of the three groups respectively, T2-weighted imaging (T2WI) was used to obtain exophthalmos and lacrimal gland exophthalmos. The long diameter, short diameter, and area of the lacrimal gland at the maximum cross section were measured on T2-weighted imaging, and the apparent dispersion coefficient (ADC) of transverse lacrimal gland was recorded. SPSS 24.0 software was used for statistical analysis, and P<0.05 was considered statistically significant. The t test of two independent samples was used to compare the quantitative data between groups. The Chi-square test was used for the differences between groups in gender, smoking history, drinking history and CAS score. Receiver operating characteristic (ROC) curve and its area under the curve (AUC) were used to evaluate the diagnostic efficiency of GO activity. Spearman's correlation analysis was used to analyze the correlation between lacrimal gland quantitative parameters and CAS score.Results (1) The parameters of ocular exophthalmia and transverse lacrimal gland, including lacrimal gland exophthalmia, long diameter, short diameter, area and ADC mean value, were increased in active phase GO group compared the inactive phase GO group and control group, while those in inactive GO group were higher compared with control group (all P<0.05). (2) ROC curve results: ocular exophthalmia and transverse lacrimal gland area had the highest diagnostic efficacy in GO patients (AUC=0.906 and 0.905), and lacrimal gland exophthalmia and the mean value of ADC in transverse lacrimal gland also had certain diagnostic values in GO patients (0.793 and 0.702). The optimal cut-off point of the optimal cut-off point of RESOLVE DWI ADC value for predicting GO activity was 1.181×10-3 mm2/s, with a sensitivity of 95.00% and a specificity of 76.30%. (3) The exophthalmis (r=0.734, P<0.05), lacrimal gland prominence (r=0.719, P<0.05), mean ADC of lacrimal gland (r=0.742, P<0.05) were strongly correlated with CAS.Conclusions The prominence of transverse lacrimal gland and the mean value of DWI ADC value can be used as important reference indexes for diagnosis and staging of ophthalmopathy of GO patients.
[Keywords] Graves ophthalmopathy；lacrimal gland；quantitative measurement；diffusion weighted imaging；magnetic resonance imaging

WANG Man1, 2   SHEN Zhongyuan3   KAN Hong3   WU Xingwang1*  

1 Deparment of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei 230032, China

2 Department of Nuclear Medicine, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, China

3 Deparment of Radiology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, China

Corresponding author: WU X W, E-mail: duobi2004@126.com

Conflicts of interest   None.

Received  2023-08-09
Accepted  2024-04-23
DOI: 10.12015/issn.1674-8034.2024.05.011
Cite this article as WANG M, SHEN Z Y, KAN H, et al. Diagnostic value of quantitative measurement of orbital structure by 3 T MRI in staging of Graves ophthalmopathy[J]. Chin J Magn Reson Imaging, 2024, 15(5): 61-67. DOI:10.12015/issn.1674-8034.2024.05.011.

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