磁共振高清弥散张量成像技术在甲状腺相关性眼病活动性分期中的价值

The Value of High Resolution Diffusion Tensor Imaging in Evaluating Disease Activity in Patients with Thyroid-Associated Ophthalmopathy

目的:研究视神经磁共振高清弥散张量成像技术(Resolve-DTI)在甲状腺相关性眼病(TAO)患者活动性分期的价值。方法:收集临床确诊的TAO患者26例(共52只眼),进行眼眶常规MRI序列扫描及Resolve-DTI序列扫描,分别测量双侧视神经的各向异性分数(FA)、表观弥散系数(ADC)、轴向弥散率(AD)及径向弥散率(RD)值,并分别对52只眼睛进行临床活动性评分(CAS)评定,比较活动期和非活动期视神经各DTI相关定量参数值的差异,分析DTI各定量参数值与CAS分值的相关性。结果:活动期TAO患者的双侧视神经的FA值明显低于非活动期(P<0.05),ADC、AD和RD与非活动期的差异均没有统计学意义(P>0.05);FA与CAS分值呈负相关(P<0.05),ADC、AD及RD值与CAS分值均没有相关性。结论:视神经Resolve-DTI技术有望为TAO患者活动性分期提供可靠的客观依据。

Purpose:To study the value of high resolution diffusion tensor imaging(Resolve-DTI)in evaluating disease activity in patients with thyroid-associated ophthalmopathy(TAO).Methods:Twenty-six patients(fifty-two eyes)with TAO were performed routine MRI sequences and Resolve-DTI on a 3.0 T MRI scanner.The fractional anisotropy(FA),ADC(apparent diffusion coefficient),axial diffusivity(AD)and radial diffusivity(RD)values of bilateral optic nerves were measured,and the clinical activity scores(CAS)for 52 eyes were evaluated.The DTI quantitative parameters of optic nerve were compared between active and inactive optic nerves,and the correlation between DTI quantitative parameters and CAS were compared respectively.Results:The FA values of optic nerves in patients with active TAO were significantly lower than in patients with inactive TAO(P<0.05),but the ADC,AD and RD values accordingly showed no statistically significant difference between the two groups(P>0.05).FA was negatively correlated with CAS,and was with statistical significance(P<0.05),but the ADC,AD and RD were not correlated with CAS.Conclusion:The Resolve-DTI technique of the optic nerve is expected to provide a reliable and objective basis in evaluating disease activity in TAO patients.