基于3T-MR图像泪腺定量测量在Graves眼病诊断及分期中的价值

The clinical value of quantitative measurements of lacrimal gland in the diagnosis and staging of Graves ophthalmopathy based on 3T-MR imaging

目的:探讨3T-MRI泪腺定量测量在Graves眼病(GO)诊断及分期中的价值。方法:对33例Graves眼病患者和24例健康人(对照组)行3.0T MR眼眶扫描,分别在横轴面及冠状面图像上测量泪腺的长径、短径、截面积,计算泪腺的体积、泪腺与同侧颞肌的信号强度比(SIR)。比较泪腺各定量参数的组间差异,采用受试者工作特征曲线(ROC)分析组间比较有差异的泪腺定量参数对GO的诊断效能。结果:GO组泪腺各定量测量参数除冠状面长径外,均明显大于正常对照组(P<0.05),以横轴面及冠状面短径增大最显著。与GO非活动期组比较,活动期组仅泪腺-颞肌SIR明显增大(P=0.001)。以泪腺-颞肌SIR≥2.57指导GO分期,可获得最优的诊断价值(AUC=0.711,敏感度57.7%,特异度77.5%)。结论:3T-MRI泪腺定量测量可辅助GO的诊断及临床分期。

Objective：To investigate the clinical value of quantitative measurements of lacrimal gland in the diagnosis and staging of Graves ophthalmopathy （GO）based on 3T-MR imaging.Methods：Thirty-three GO patients （patient group） and twenty-four healthy volunteers （control group）were enrolled in our study and 3 .0T MR orbit scans were performed. Quantitative parameters of lacrimal gland,including length,width,area,volume and signal intensity ratio of lacrimal gland to the ipsilateral temporal muscle （SIR value）were measured on the horizontal axial and coronal image respectively.The difference of quantitative parameters between GO patients and healthy controls,or between active and inactive GOs were compared with t test.Receiver operating characteristic （ROC）analyses were used to evaluate the diagnostic value of the sig-nificant parameters in discrimination of GO patients from healthy controls,or active from inactive GOs.Results：All the quantitative parameters were significantly larger in the GO group than in the control group （P〈0.05）,except the coronal length.The increase of width was most remarkable on axial and coronal plane.Only SIR was significantly increased in active GOs when compared with inactive GOs （P= 0.001）.Setting the SIR of 2.57 as the threshold value,the optimal staging val-ue could be achieved （AUC,0.711;sensitivity,57.7%;specificity,77.5%）.Conclusion：Quantitative measurements of lacri-mal gland based on 3T MR imaging could assist in diagnosis and staging of Graves ophthalmopathy.