Radiological Activity Score (RAS)-MRI Characteristics in Dysthyroid Optic Neuropathy in a Multi-Ethnic Thyroid Eye Disease Population.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-05-20 DOI:10.1111/cen.15272

Malik Moledina, Vickie Lee, Kunwar Bhatia, Gitta Madani, Claire Feeney, Nicole George, Nour Houbby, Daisy Metcalf, Natalie Man, Rajni Jain, Ahmad Aziz, Ravi Kumar Lingam

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引用次数: 0

Abstract

Purpose: Dysthyroid Optic Neuropathy (DON) is a sight threatening and diagnostically challenging complication of Thyroid Eye Disease (TED). We provide a comparative analysis of the MRI features associated between patietnts with and without DON.

Methods: Anonymised retrospective cohort study of patients with TED over eleven years. All patients had Axial T1-weighted and coronal 3 mm MRI STIR images. In a subset, a 3-mm-thick non-echoplanar HASTE DWI sequence was acquired in the coronal plane, and an ADC map was calculated using the diffusion scan raw data. Assessment of apical crowding (AC), extraocular muscle (EOM) enlargement (E), peri-muscular fat (PMF)/muscle signal intensity (SI) and Apparent Diffusion Coefficient (ADC) were analysed on coronal images.

Results: Twenty-six consecutive DON and 516 non-DON cases. In the DON group, elevated EOMSI, PMFSI, EOME and AC were present in 54.6%, 25.9%, 72.7% and 64.6%, respectively, compared to 24.1%, 6.2%, 42.1% and 5.9% in the non-DON (p = 0.001, p = 0.000, p = 0.001 and p = 0.000). The average ADC value in the DON cohort was 1373 ± 319 versus 973 ± 237 in the non-DON (p = 0.000). Likelihood of DON on Univariable Regression Analysis (Odds Ratios): Apical Crowding (29.1 x p = 0.000) and ADC Value ≥ 1200 (7.3 x p = 0.000). On Multivariable Regression Analysis (Odds Ratios): Apical Crowding 22.1 x (p = 0.000) and ADC Value ≥ 1200 3.7 x (p = 0.027).

Conclusion: MRI features associated with a higher diagnostic likelihood of DON include significant AC and elevated ADC values. ADC may show reasonable promise in diagnosing and predicting DON.

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多民族甲状腺眼病人群甲状腺功能障碍视神经病变的放射活动评分(RAS)-MRI特征

目的：甲状腺功能障碍视神经病变（DON）是甲状腺眼病（TED）的一种威胁视力和诊断挑战性的并发症。我们提供了一个比较分析的MRI特征之间的患者有和没有DON。方法：对11年以上的TED患者进行匿名回顾性队列研究。所有患者均有轴向t1加权和冠状3 mm MRI STIR图像。在一个子集中，在冠状面获得一个3 mm厚的非回声平面HASTE DWI序列，并使用扩散扫描原始数据计算ADC图。分析冠状面图像的尖部拥挤（AC）、眼外肌（EOM）增大(E)、肌周脂肪(PMF)/肌肉信号强度（SI）和表观扩散系数（ADC）。结果：连续DON 26例，非DON 516例。DON组的EOMSI、PMFSI、EOME和AC分别升高54.6%、25.9%、72.7%和64.6%，而非DON组的EOMSI、PMFSI、EOME和AC分别升高24.1%、6.2%、42.1%和5.9% （p = 0.001, p = 0.000, p = 0.001和p = 0.000）。DON组的平均ADC值为1373±319，非DON组为973±237 （p = 0.000）。单变量回归分析DON的可能性（优势比）：根尖拥挤（29.1 x p = 0.000）和ADC值≥1200 （7.3 x p = 0.000）。多变量回归分析（优势比）：根尖拥挤22.1 x (p = 0.000)， ADC值≥1200 3.7 x （p = 0.027）。结论：与DON诊断可能性较高的MRI特征包括显著的AC和升高的ADC值。ADC在诊断和预测DON方面有一定的应用前景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.