摘要
目的:通过分析甲状腺相关眼病(TAO)患者糖皮质激素治疗前后眼眶内容物MRI各参数的变化,探讨MRI定量测量对TAO糖皮质激素治疗疗效评价的价值。方法:回顾性分析糖皮质激素治疗前后行眼眶3.0 T MRI检查的活动期TAO患者37例,根据患者主要症状、体征改善情况及临床活动度评分(CAS)变化分为有效组(23例)和无效组(14例),测量2组双眼治疗前后眼球突出度、眼球内侧脂肪厚度、眼外肌最大截面积、眼外肌与同侧颞肌的信号强度比(SIR_(眼外肌/颞肌)),分析治疗前后各参数的变化与CAS变化的相关性。结果:有效组治疗前后SIR_(眼外肌/颞肌)、CAS差异均有统计学意义(均P<0.001)。Spearman相关性分析表明,有效组治疗前后SIR_(眼外肌/颞肌)差值与CAS差值相关(r=0.801,P<0.001)。ROC曲线分析表明,SIR_(眼外肌/颞肌)治疗前后差值对疗效判断具有一定参考价值(AUC=0.898,P<0.001)。结论:MRI定量测量SIR_(眼外肌/颞肌)可评估激素治疗活动期TAO的效果,为临床疗效评价提供依据。
Objective:By analyzing the changes of orbital contents MRI parameters before and after glucocorticoid treatment in patients with thyroid associated ophthalmopathy(TAO),the evaluation value of MRI quantitative measurement on the therapeutic effect of TAO glucocorticoid treatment was discussed.Methods:A retrospective analysis of 37 cases of active TAO who underwent orbital MRI before and after glucocorticoid treatment,and 37 patients were divided into the effective group(23 cases)and the ineffective group(14 cases),according to the improvement of main symptoms and signs of patients and changes in clinical activity score(CAS),the protruding degree of the eyeball,the thickness of the medial fat,the maximum cross-sectional area of each extraocular muscle,signal intensity ratio(SIR)of extraocular muscle to ipsilateral temporal muscle were measured.To the correlation between the changes of parameters before and after treatment and the changes of CAS were analyzed.Results:The SIR value and CAS before and after treatment in the effective group were different significantly(both P<0.001).Spearman correlation analysis showed that the difference value of SIR before and after treatment in the effective group was related to the difference value of CAS(r=0.801,P<0.001).ROC analysis of SIR difference value before and after treatment showed a certain reference value for judging the curative effect(AUC=0.898,P<0.001).Conclusion:MRI quantitative measurement of SIR value can effectively evaluate the therapeutic effect of glucocorticoids in TAO.
作者
张羽
刘许慧
滕剑
王睿
彭飞
傅迎霞
王建华
张宗军
黄德健
ZHANG Yu;LIU Xuhui;TENG Jian;WANG Rui;PENG Fei;FU Yingxia;WANG Jianhua;ZHANG Zongjun;HUANG Dejian(Department of Radiology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine,Nanjing 210028,China)
出处
《中国中西医结合影像学杂志》
2022年第1期41-45,共5页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
2019年江苏省卫健委课题(BJ18029)。
作者简介
通信作者:王睿,Email:624417999@qq.com。
