MRI测量眼眶不同部位脂肪体积在TAO诊断中的价值

The value of fat volume in different parts of orbit under MRI in TAO diagnosis

目的探讨MRI测量眼眶不同部位脂肪体积在甲状腺相关性眼病(TAO)诊断中的价值,寻找诊断最适临界值,为TAO的诊断提供依据。方法选取新发TAO患者47例为研究组,依据CAS评分分为活动组31例及非活动组16例,另选取30例为正常对照组。通过Philips公司3.0 T磁共振扫描仪对眼眶进行扫描,测量眼球的突出值、眶前脂肪体积、眶内脂肪体积及眼眶脂肪总体积等指标,分析不同部位脂肪体积与患者突眼度及CAS评分之间的相关性,ROC曲线分析寻找诊断最适临界值。结果活动组与非活动组、活动组与正常对照组、非活动组与正常对照组间眶前脂肪体积、眶内脂肪体积及眼眶脂肪总体积差异有统计学意义(P<0.05);TAO患者眶前脂肪体积、眶内脂肪体积及眼眶脂肪总体积与患者突眼度、CAS临床评分指标间存在相关性。经ROC曲线分析眶前脂肪体积、眶内脂肪体积、眼眶脂肪总体积在TAO诊断中的临界值分别为3.18、13.26、15.65,敏感度分别为89.4%、87.2%、95.7%,特异度分别为95.5%、96.8%、96.8%。结论 TAO患者眶前脂肪体积、眶内脂肪体积及眼眶脂肪总体积与患者突眼度、CAS临床评分指标间存在相关性,MRI测量眼眶不同部位脂肪体积在甲亢性眼病诊断中具有一定的价值。

Objective To investigate the value of fat volume in different parts of orbit under MRI in the diagnosis of thyroid associated ophthalmopathy（ TAO） in order to find the optimal critical value,and provide the basis for the diagnosis of TAO. Methods 47 cases of new onset TAO patients were selected and they were grouped to active group of 31 cases and non-active group of 16 cases,according to the CAS score of the patients,normal control group had 30 cases. The orbit was scanned via Philips 3. 0 T and the protrusion value of eyeball,anterior-orbit fat volume,retrobulbar fat volume and overall orbital fat volume as well as other indexes were measured. The correlation between the CAS scores or fat volume and exorbitism degree of different parts were analyzed statistically. The ROC curve was analyzed to find the optimal diagnostic critical value. Results The inter-group differences between active group and inactive group,active group and normal control group,non active group and normal control group were statistically significant P 〈0. 05. The anterior-orbit fat volume,retrobulbar fat volume and overall orbital fat volume of TAO patients were correlated with the patients＇ exorbitism degree and the CAS clinical score indexes. The critical values of anterior-orbit fat volume,retrobulbar fat volume and overall orbital fat volume underwent ROC curve analysis in the diagnosis of TAO were 3. 18 cm3,13. 26 cm3 and 15. 65 cm3 respectively,the sensitivity was 89. 4%,87. 2% and 95. 7% respectively,the specificity was 95. 5%,96. 8% and 96. 8% respectively. Conclusion The anterior-orbit fat volume,retrobulbar fat volume and overall orbital fat volume of TAO patients are correlated with exorbitism degree and the CAS clinical score indexes. Fat volume of different parts of orbit under MRI has certain value and clinical application prospect in the diagnosis of thyroid eye disease.