提上睑肌MRI改变与Graves眶病上睑迟落的相关性研究

The study on correlation of levator palpebrae superioris muscle MRI findings and Graves orbitopathy with upper eyelid lag

目的探讨提上睑肌MRI改变与Graves眶病上睑迟落的相关性。设计前瞻性病例系列。研究对象20例(20眼)正常志愿者,8例(10眼)Graves眶病无上睑迟落患者,7例(10眼)上睑迟落患者。方法受检者应用眼表面线圈,于前视眼位、上视眼位及下视眼位行斜冠状面、斜矢状面T_1WI扫描。主要指标各眼位提上睑肌横截面积、厚度,腱膜上方脂肪厚度,提上睑肌收缩率、舒张率。结果正常者提上睑肌各眼位横截面积、厚度、腱膜上方脂肪厚度、收缩率、舒张率在侧别、性别及年龄间差异无统计学意义(P均>0.05)。提上睑肌在上视眼位横截面积(17.93±4.48)mm^2、厚度(2.21±0.22)mm较前视眼位增加,下视眼位横截面积(5.48±1.32)mm^2、厚度(1.11±1.15)mm较前视眼位减小(P均<0.05)。Graves眶病患者各眼位提上睑肌横截面积、厚度及腱膜上方脂肪厚度较正常者均增加,提上睑肌收缩率、舒张率均减小(P均<0.05)。迟落征患者较无迟落征患者,下视眼位提上睑肌厚度(2.74±0.71)mm及腱膜上方脂肪厚度(1.94±0.54)mm明显增加,面积舒张率0.12±0.14和厚度舒张率0.11±0.08明显减小(P均<0.05)。结论Graves眶病患者下视眼位提上睑肌厚度、舒张率及腱膜上方脂肪厚度的变化与上睑迟落关系密切。

Objective To investigate the correlation of levator palpebrae superioris muscle （LPS） MRI findings and Graves orbitopathy with upper eyelid lag. Design Prospective case series. Participants 20 normal individuals （20 eyes）, 8 patients （10 eyes） of Graves orbitopathy without upper eyelid lag, 7 patients （10 eyes） of Graves orbitopathy with upper eyelid lag. Methods The subjects were examed with the eye surface coil at primary , upper and downward position under T1WI. Main Outcome Measures Area, thickness of LPS at every eye position, thickness of fat over LPS aponeurosis and the systolic rate, diastole rate. Results There were no statistically significant differences in area, thickness, thickness of fat, systolic rate, diastole rate of LPS in normal individuals among side,gender and age （all P〉0.05）. The area 17.93±4.48 mm2 and thickness 2.21±0.22 mm at upper eye position were larger than those at primary eye position, the area 5.48±1.32 mm2 and thickness 1.11±1.15 mm at downward position were smaller than those at primary eye position （all P〈0.05）. The area, thickness of LPS of Graves orbitopathy patients at every eye position and the thickness of fat over LPS aponeurosis were larger than those of normal individuals , the systolic rate and diastole rate were smaller than those of normal individuals （all P〈0.05）. Compared with Graves orbitopathy patients without upper eyelid lag, the thickness 2.74±0.71mm at downward position, fat thickness 1.94±0.54mm of patients with upper eyelid lag increase markedly, and the area diastole rate 0.12±0.14, thickness diastole rate 0.11 ±0.08 decrease markedly （all P〈0.05）. Conclusion This investigation suggests that there are close correlation between thickness at downward position, fat thickness, diastole rate and upper eyelid lag in patients with Graves orbitopathy.