Korean J Radiol.  2020 Mar;21(3):332-340. 10.3348/kjr.2019.0053.

Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using Readout-Segmented Echo-Planar Imaging-Based Diffusion Tensor Imaging

Affiliations
  • 1Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. njmu_yt@sina.com
  • 2Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Abstract


OBJECTIVE
We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroid-associated orbitopathy (TAO) as well as in evaluating disease activity.
MATERIALS AND METHODS
We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPI-based DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity.
RESULTS
Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%).
CONCLUSION
rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.

Keyword

Thyroid-associated orbitopathy; Extraocular muscle; Optic nerve; Diffusion tensor imaging; Readout-segmented echo-planar imaging

MeSH Terms

Anisotropy
Diffusion Tensor Imaging*
Diffusion*
Echo-Planar Imaging
Humans
Logistic Models
Multivariate Analysis
Muscles*
Negotiating
Optic Nerve*
Orbit
Sensitivity and Specificity
Smoke
Smoking
Troleandomycin
Smoke
Troleandomycin
Full Text Links
  • KJR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error