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• Clinical Article •
Relationship between orbital tissues and diplopia in thyroid-associated ophthalmopathy based on MRI
SHI Guifeng  DUAN Yongbo  HUANG Kai  LIU Dan  CHEN Haixiong 

Cite this article as: SHI G F, DUAN Y B, HUANG K, et al. Relationship between orbital tissues and diplopia in thyroid-associated ophthalmopathy based on MRI[J]. Chin J Magn Reson Imaging, 2024, 15(9): 53-59, 67. DOI:10.12015/issn.1674-8034.2024.09.010.


[Abstract] Objective 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 independent risk factors of TAO diplopia, and the receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic efficacy of individual and combined indicators for TAO diplopia. The ROC analysis showed that the combined index had the best diagnostic efficacy, AUC=0.853 (95% confidence interval: 0.792-0.915) (P<0.001), sensitivity was 82.7%, and specificity was 79.6%, the Yoden index is 0.623.Conclusions TAO diplopia is not only related to the enlargement of extraocular muscles and SIR values mentioned in previous studies, but also closely related to the volume of intraorbital fat. Comprehensive analysis of extraocular muscles and orbital fat can provide a more comprehensive and objective basis for clinical practice, which is helpful for clinical selection of appropriate treatment options.
[Keywords] thyroid-associated ophthalmopathy；diplopia；extraocular muscles；fat volume；magnetic resonance imaging

SHI Guifeng1, 2   DUAN Yongbo3   HUANG Kai1, 2   LIU Dan1, 2   CHEN Haixiong2*  

1 The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510000, China

2 Department of Radiology, Shunde Hospital of Southern Medical University (First People's Hospital of Shunde District, Foshan City), FoShan 528300, China

3 Department of Ophthalmology, Shunde Hospital of Southern Medical University (First People's Hospital of Shunde District, Foshan City), Foshan 528300, China

Corresponding author: CHEN H X, E-mail: 13825553451@139.com

Conflicts of interest   None.

Received  2024-05-07
Accepted  2024-08-12
DOI: 10.12015/issn.1674-8034.2024.09.010
Cite this article as: SHI G F, DUAN Y B, HUANG K, et al. Relationship between orbital tissues and diplopia in thyroid-associated ophthalmopathy based on MRI[J]. Chin J Magn Reson Imaging, 2024, 15(9): 53-59, 67. DOI:10.12015/issn.1674-8034.2024.09.010.

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