Magnetic resonance imaging of extraocular rectus muscles abnormalities in acute acquired concomitant esotropia

AIM:To investigate the difference of medial rectus(MR)and lateral rectus(LR)between acute acquired concomitant esotropia(AACE)and the healthy controls(HCs)detected by magnetic resonance imaging(MRI).METHODS:A case-control study.Eighteen subjects with AACE and eighteen HCs were enrolled.MRI scanning data were conducted in target-controlled central gaze with a 3-Tesla magnetic resonance scanner.Extraocular muscles(EOMs)were scanned in contiguous image planes 2-mm thick spanning the EOM origins to the globe equator.To form posterior partial volumes(PPVs),the LR and MR cross-sections in the image planes 8,10,12,and 14 mm posterior to the globe were summed and multiplied by the 2-mm slice thickness.The data were classified according to the right eye,left eye,dominant eye,and non-dominant eye,and the differences in mean cross-sectional area,maximum cross-sectional area,and PPVs of the MR and LR muscle in the AACE group and HCs group were compared under the above classifications respectively.RESULTS:There were no significant differences between the two groups of demographic characteristics.The mean cross-sectional area of the LR muscle was significantly greater in the AACE group than that in the HCs group in the non-dominant eyes(P=0.028).The maximum cross-sectional area of the LR muscle both in the dominant and non-dominant eye of the AACE group was significantly greater than the HCs group(P=0.009,P=0.016).For the dominant eye,the PPVs of the LR muscle were significantly greater in the AACE than that in the HCs group(P=0.013),but not in the MR muscle(P=0.698).CONCLUSION:The size and volume of muscles dominant eyes of AACE subjects change significantly to overcome binocular diplopia.The LR muscle become larger to compensate for the enhanced convergence in the AACE.

Diffusion tensor imaging of horizontal extraocular muscles in patients with concomitant and paralytic esotropia

AIM:To assess metrics of diffusion tensor imagining(DTI)in evaluating microstructural abnormalities of horizontal extraocular muscles(EOM)in esotropia.METHODS:Six adult concomitant esotropia patients,5 unilateral abducent paralysis patients and 2 healthy volunteers were enrolled.Conventional magnetic resonance imaging(MRI)and DTI were performed on all subjects using 3T MR scanner.Fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD)of medial and lateral rectus muscles were measured and compared between patients group and control group.RESULTS:Medial rectus MD and RD within the adducted eye of concomitant patients was significantly greater than that in unilateral abducent paralysis patients(0.259×10-2 mm^(2)/s vs 0.207×10-2 mm^(2)/s,P=0.014;0.182×10-2 mm^(2)/s vs 0.152×10-2 mm^(2)/s,P=0.017).Both strabismus patients showed a significantly decreased MD and AD than that obtained in normal controls for lateral rectus muscles(P<0.05).Medial rectus MD of the adducted eye in concomitant strabismus patients was significantly decreased than that in healthy controls(0.259×10-2 mm^(2)/s vs 0.266×10-2 mm^(2)/s,P=0.010).Lateral rectus AD of the adducted eye in concomitant strabismus patients was significantly decreased as compared with that in healthy controls(0.515×10-2 mm^(2)/s vs 0.593×10-2 mm^(2)/s,P=0.013).No statistically significant differences were present between the adducted and fixating eyes in concomitant strabismus patients.CONCLUSION:DTI represents a feasible technique to assess tissue characteristics of EOM.The effects of eye position changes on DTI parameters are subtle.Decreased MD and RD could be evidence for remodeling of the medial rectus muscle contracture.Lower medial and lateral recuts MD of concomitant esotropia patients indicates a thinner fibrous structure of the EOM.Lower MD and AD should be general character of esotropia.

Myopathological features in MELAS syndrome without significant changes in muscle biopsy pathology

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes （MELAS） are common types of mitochondrial encephalomyopathy. The involved muscular pathology is characterized by typical changes of mitochondrial abnormalities. Gene screening has been the gold diagnostic standard for MELAS diagnosis. This study presents three primary MELAS patients, with an age of onset from 13 to 18 years, including one patient with seizure, and two with headache and vomiting. All patients had a family history of disease, with maternal inheritance. Cerebral magnetic resonance imaging revealed abnormally high signals in T2-weighted images： temporal lobe in three cases, occipital lobe in two cases, and parietal lobe in one case. Migrating stroke-like lesions were confirmed in one patient. Muscle biopsy revealed several strongly succinate dehydrogenase-reactive vessels scattered in muscle sections of three patients, but ragged-red fibers and cytochrome c oxidase-negative/dense （COX-/＋） fibers were not observed. Mitochondrial DNA A3243G mutation was identified in all three cases. MELAS syndrome has obvious clinical heterogeneity, and muscle weakness was not prominent in some of the cases. Muscle pathological changes did not accompany ragged-red fibers or COX-/＋ fibers, but succinate dehydrogenase- reactive vessels are important for MELAS diagnosis.

Establishment of an acute extraocular muscle injury model in cats

AIM： To describe an acute extraocular muscle injury model in cats. METHODS： Seventy-two cats were randomly divided into 6 groups（12 cats per group）. Cats＇ left lateral recti were clamped using a surgical needle holder with a clamping strength of 2（Groups A and D）, 4（Groups B and E） and 6 kg（Groups C and F）. The right lateral recti were treated as controls. On the 4^（th） and 7^（th） days, hematoxylin eosin（HE） staining, immunohistochemical staining for proliferating cell nuclear antigen（PCNA）, muscle force measurements and ocular alignment changes were performed to evaluate the extent of injuries. RESULTS： The morphological changes were graded as mild, moderate or severe by HE staining in all experiment groups. PCNA immunohistochemical staining indicated repairment of muscle fibers in the damaged area. On the 4^（th） and 7^（th） days after clamping, the injured lateral muscle exhibited an elevated threshold for electric stimulation. The muscle forces among groups 2, 4 and 6 kg injury at 4 d（Groups A, B and C） were statistically significant（P0.05）, respectively. In addition, medial deviation in ocular alignment was also present to various degrees in all groups. CONCLUSION： A cat model of acute extraocular muscle injury can be established by rectus clamping. Different clamping strengths can make different degrees of muscle injury. This model may help the future study in the acute extraocular muscle injury.

The Suh Muscle Hook: A New Muscle Hook for Tight Extraocular Muscles during Strabismus Surgery

Purpose: To introduce an advanced muscle hook to decrease risks and create more feasible extraocular muscle surgeries for physicians. Case Report: Tight extraocular muscles during strabismus surgery could be extremely challenging even in experienced hands due to restricted globe rotation, limited view, and lack of muscle elasticity. Although a variety of surgical instruments have been introduced through the years, traditional muscle hooks such as the Jameson hook are largely unchanged and are bulky and cumbersome. Using the traditional muscle hook under situations such as pediatric strabismus surgery with smaller eyes and extraocular muscles may increase the risk of perforating the globe or even rupturing the muscles. We developed the “Suh muscle hook”, which has a 0.55 mm wide grooved track in a 1.1 mm wide horizontal bar, a semi-sharp dissecting tip, and a 30-degree bending near the handle accommodating for nasal bridge to better facilitate surgeons dealing with tight extraocular muscles and minimize risks during strabismus surgery.

Evaluation of nintedanib as a new postoperative antiscarring agent in experimental extraocular muscle surgery

AIM:To investigate the efficacy of nintedanib on reducing postoperative inflammation,fibrosis and adhesion formation following extraocular muscle surgery in rabbits in comparison with triamcinolone acetonide(TA).METHODS:Reinsertion of superior rectus muscle in right eyes of 30 New Zealand white rabbits were performed.They were randomized to receive one of the following treatments:0.9%normal saline,one of 1-,5-,and 10μmol doses of nintedanib subconjunctivally immediately after surgery and on postoperative day 1,2,3,5,and 7,and TA immediately after surgery.As a control group,unoperated left eyes(n=6)were used.On the 28 th day,six eyes from each group were enucleated and histopathologically and immunohistochemically analyzed to assess the postoperative inflammatory changes,fibrosis and adhesion.Transforming growth factor beta,matrix metalloproteinase-2 and alpha smooth muscle actin expressions were evaluated.RESULTS:Conjunctival and scleral inflammation in TA and nintedanib groups were significantly reduced compared to saline(sham)group.Conjunctival vascularity and rectus muscle fibrosis were significantly reduced in 10μmol nintedanib group.Nintedanib groups were the most effective groups in reduction of perimuscular fibrosis.Neither three nintedanib groups nor TA group differed statistically from sham group with regard to adhesion.The expressions of transforming growth factor beta,alpha smooth muscle actin and matrix metalloproteinase-2 were reduced in nintedanib groups compared to saline group.CONCLUSION:Nintedanib appears to attenuate postoperative inflammation and fibrosis after extraocular muscle surgery.Nintedanib may be a safer and stronger alternative agent in extraocular muscle surgery when compared to steroids.Further investigation is needed to prove antiadhesive effect of nintedanib.

Study on normal ophthalmic tissues among ocular volume and extraocular muscles structure measurement by HR-MRI

Objective: To measure the ocular volume and extraocular muscles of healthy people using the high-resolution magnetic reso-nance imaging (HR-MRI) technology, to provide parameters support for eye research, teaching and diagnosis. Methods: The study collected 100 cases of normal subjects (200 eyes) from November 2012 to December 2013, including 50 males and 50 females, accepted line HR-orbital MRI, and image processing software was applied to morphology and statistical analysis. The extraocular muscles, muscle belly level horizontal diameter and maximum diameter vertical diameter were mea-sured. Results: The volume of the vitreous cavity (4.51 ± 0.26) cm3 had no significant difference with the anatomic normal value (p= .148);The volumes of the ocular globe, the anterior chamber and the lens cavity were (5.05 ± 0.21) cm3, (0.24 ± 0.26) cm3, (0.23 ± 0.14) cm3, with no statistic differences compared with those of the anatomic normal values. The extraocular muscles of normal Chinese were symmetrical on the two sides. The relationships of the short diameters of extraocular muscles in the maximum planes were: inferior rectus muscle (IR) > medial rectus muscle (MR) > superior rectus (SR) > lateral rectus muscle (LR). Those of the long diameters of extraocular muscles were: LR > MR > SR > IR. Conclusions: MRI can be used for measuring ocular volume and sizes of extraocular muscles. Compared with the anatomic normal value, the sizes of extraocular muscles can also be assessed by the symmetry on the two sides and by observing the usual rule of extraocular muscles.

Metastatic low-grade endometrial stromal sarcoma with sex cord and smooth muscle differentiation: A case report

BACKGROUND Metastatic low-grade endometrial stromal sarcoma(LG-ESS) with sex cord-like and smooth muscle-like differentiation is rare. This article reports such a case with multiple recurrences and with extensive pelvic and abdominal metastasis.CASE SUMMARY A 47-year-old female patient was diagnosed with multiple cystic masses in the pelvic cavity by magnetic resonance imaging examination. Based on the postoperative pathological and immunohistochemical analyses of the surgical specimen, she was diagnosed with a metastatic low-grade endometrial stromal sarcoma with sex cord and smooth muscle differentiation.CONCLUSION LG-ESS is a low-grade malignant tumor with a high recurrence rate and metastasis probability. It is easily misdiagnosed initially. It is essential to distinguish LG-ESS with sex cord-like differentiation from uterine tumour resembling ovarian sex cord tumour.

Skeletal muscle metastases of hepatocellular carcinoma: A case report and literature review

BACKGROUND The metastasis of liver cancer to skeletal muscle is extremely rare compared to other sites.We herein report a case of rapidly developing skeletal metastases following liver transplantation due to primary liver cancer.CASE SUMMARY A 70-year-old male with underlying chronic hepatitis B virus infection was diagnosed with hepatocellular carcinoma(HCC),for which he underwent liver transplantation in 2014.Six years after receiving the transplant,pathological examination confirmed the presence of HCC without vascular invasion.He was admitted to the hospital with a rapidly growing mass on his right thigh.Ultrasound examination revealed a mixed echo mass in the lateral soft tissue of the middle part of the right femur.Magnetic resonance imaging showed heterogeneous iso-signal intensity on T1-weighted images and heterogeneous hyper-intensity on T2-weighted images compared to the surrounding muscles.Pathological examination of the ultrasound-guided needle biopsy specimen revealed that it was similar to the previously detected liver cancer;the diagnosis was metastasis of HCC.Surgical excision was performed.There were no other sites of metastasis,and the patient recovered well after surgery.CONCLUSION This report presents a rare case of skeletal metastasis following liver transplantation for HCC.The study suggests a possible role for skeletal muscle metastasis mechanisms,which should be the focus of future research.

Time-dependent Appearances of Myofibroblasts during the Re- pair of Contused Skeletal Muscle in Rat and Its Application for Wound Age Determination

Objective To research the relation between the time-dependent appearances of myofibroblasts during the repair of contused skeletal muscle in rat and wound age determination. Methods A total of 35 SD male rats were divided into the control and six injured groups according to wound age as follows: 12 h, 1 d, 5 d, 7 d, 10 d and 14 d after injury. The appearances of myofibroblasts were detected by HE staining, immunohistochemistry and confocal laser scanning microscopy. Masson's trichrome staining was utilized to examine collagen accumulation in the contused areas. Results Immunohistochemical staining showed that α-SMA+myofibroblasts were initially observed at 5 d post-injury. The average ratio of myofibroblasts was highest at 14 d post-injury, with all samples, ratios more than 50%. In the other five groups, the average of α-SMA positive ratios were less than 50%. The collagen stained areas in the contused zones, concomitant with myofibroblast appearance, were increasingly augmented along with advances of posttraumatic interval. Conclusion The immunohistochemical detection of myofibroblasts can be applied to wound age determination. The myofibroblasts might be involved in collagen deposition during the repair of contused skeletal muscle in rat.

铁死亡诱导剂RAS合成致死分子3抑制病理性瘢痕成纤维细胞的纤维化

背景:病理性瘢痕主要表现为异常的细胞外基质积累和过度的成纤维细胞增殖,成纤维细胞过度增殖就会产生大量以胶原纤维为主的细胞外基质。因此深入探讨成纤维细胞纤维化在病理性瘢痕形成中的作用,将为揭示病理性瘢痕的机制和生物学治疗提供新思路。目的:探讨铁死亡诱导剂RAS合成致死分子3(RAS-selective lethal small molecule 3,RSL3)对人病理性瘢痕成纤维细胞纤维化的影响。方法:收集10例宁夏医科大学总医院烧伤整形美容科提供的病理性瘢痕组织和同一个体正常皮肤组织,提取人病理性瘢痕成纤维细胞和人正常皮肤成纤维细胞用于后续实验;苏木精-伊红染色观察病理性瘢痕组织和正常皮肤组织的形态;倒置显微镜观察病理性瘢痕成纤维细胞和正常皮肤成纤维细胞的外观形态;免疫荧光实验验证所提取的细胞是否为成纤维细胞;用不同浓度的RSL3(1,3,5,7,9,11,13μmol/L)干预细胞,CCK-8法检测RSL3作用于成纤维细胞的半数抑制浓度(IC_(50));设置对照组(不做处理)和RSL3干预组(用7μmol/L的RSL3干预细胞24 h),qRT-PCR和Western blot检测谷胱甘肽过氧化物酶4、Ⅰ型胶原蛋白、Ⅲ型胶原蛋白和α-平滑肌肌动蛋白的mRNA和蛋白的表达;检测细胞丙二醛浓度;划痕试验检测细胞划痕后24 h剩余划痕面积,并计算剩余划痕面积百分比。结果与结论:①与正常皮肤组相比,病理性瘢痕组的谷胱甘肽过氧化物酶4高表达(mRNA:t=3.252,P<0.01;蛋白:t=5.075,P<0.01);②与正常皮肤成纤维细胞组相比,病理性瘢痕成纤维细胞组的谷胱甘肽过氧化物酶4高表达(mRNA:t=10.32,P<0.01;蛋白:t=26.22,P<0.01);③与对照组相比,RSL3干预组谷胱甘肽过氧化物酶4表达减少(mRNA:t=2.798,P<0.05;蛋白:t=4.643,P<0.01),丙二醛浓度上升(t=2.917,P<0.05),Ⅰ型胶原蛋白(mRNA:t=15.84,P<0.01;蛋白:t=4.610,P<0.01)、Ⅲ型胶原蛋白(mRNA:t=28.86,P<0.01;蛋白:t=7.713,P<0.01)和α-平滑肌肌动蛋白(mRNA:t=2.671,P<0.05;蛋白:t=7.417,P<0.01)的表达减少,迁移能力减弱(t=14.06,P<0.01);④提示RSL3通过抑制谷胱甘肽过氧化物酶4的表达,进而抑制病理性瘢痕成纤维细胞的纤维化和迁移能力。

骨骼肌单器官血管炎下肢肌肉磁共振成像特征及分型

目的:探究骨骼肌单器官血管炎(SoSMV)患者下肢肌肉磁共振成像(MRI)特征和临床分型。方法:回顾分析中日友好医院炎性肌病研究室/肌炎重点实验室2017年1月—2022年12月肌肉病理确诊的SoSMV患者的肌肉病理以及下肢肌肉MRI,包括治疗前的T1加权像(T1WI)、T2加权脂肪抑制像(T2WI-fs)和钆增强T1加权脂肪抑制像(Gd-T1WI-fs)。结果:共纳入SoSMV患者13例,其中男7例,女6例,中位发病年龄49岁。根据患者下肢肌肉MRI和肌肉病理特征,将患者分为2个亚型。1型SoSMV(n=6)患者下肢肌肉MRI均表现为受累肌肉明显肿胀,T1WI上表现为低信号伴有肌间脂肪信号数量减少,T2WI-fs上表现为弥漫分布的高信号,Gd-T1WI-fs上2例表现为比较均匀的强化;肌肉病理4例表现为坏死性血管炎,5例出现管腔闭塞,5例肌纤维变性、坏死伴炎细胞浸润和纤维脂肪组织增生。2型SoSMV(n=7),肌肉MRI均表现为受累肌肉无明显肿胀,T2WI上肌肉内可见边界不清的分枝状条纹高信号,即“鱼骨征”,相应部位在T1WI上的信号无异常,在Gd-T1WI-fs上3例表现为轻度强化;肌肉病理7例均表现为非坏死性血管炎伴血管周围炎。2型SoSMV患者的持续缓解率高于1型。结论:SoSMV患者下肢肌肉MRI和肌肉病理具有特征性表现,在SoSMV的诊断、分型和预后判断上为潜力指标。

表观弥散系数定量评估兔肢体高压电烧伤早期肌肉进行性损伤

目的观察表观弥散系数(ADC)定量评价兔肢体高压电烧伤早期肌肉进行性损伤的价值。方法选取20只健康成年兔建立兔肢体高压电烧伤模型,并将其随机分为0.5、24、48及72 h组,每组5只,分别于造模后各相应时间采集右后肢MR弥散加权成像(DWI),并于其后取双侧肢体肌肉行HE染色;对比各组电流入口及出口损伤核心肌肉与正常肌肉的ADC、肌纤维密度(MFD)及肌纤维短径(D)值,分析兔损伤核心肌肉ADC值与MFD及D值的相关性。结果各组内入口及出口损伤核心肌肉与正常肌肉ADC值、入口与出口损伤核心肌肉ADC值差异均有统计学意义(P均<0.05);入口及出口核心损伤肌肉ADC值随造模时间延长而降低(P均<0.05),而正常肌肉ADC值在不同时间点差异无统计学意义(P>0.05)。入口及出口损伤核心肌肉MFD值随造模时间延长而降低(P均<0.05),而正常肌肉MFD值,以及入口、出口损伤核心和正常肌肉D值在造模不同时间点差异均无统计学意义(P均>0.05)。损伤核心肌肉ADC与MFD值正相关(r_(s)=0.846,P<0.05)、与D值呈负相关(r=-0.507,P<0.05)。结论ADC可定量评价兔肢体高压电烧伤早期肌肉进行性损伤。

基于组织及病理变化探讨筋针疗法对慢性骨骼肌损伤的效应机制

目的基于组织及病理变化探讨筋针疗法对慢性骨骼肌损伤的效应机制。方法选取健康雄性SD大鼠12只,采用随机数字表法分为对照组6只,造模成功后不处理;实验组6只,造模成功后给予筋针疗法治疗。比较2组雌激素相关受体α(ERRα)、乙酰化酶3(SIRT3)、锰超氧化物歧化酶(SOD2)蛋白表达,肌酸激酶(CK)、乳酸脱氢酶(LDH)活性。结果实验组ERRα、SIRT3、SOD2蛋白表达均高于对照组(P<0.05);实验组CK、LDH表达均低于对照组(P<0.05)。结论筋针治疗慢性骨骼肌损伤通过调控线粒体生物合成,降低氧化应激反应,有利于慢性骨骼肌的修复。

杵针治疗眼外肌麻痹的临床疗效观察

目的:探讨杵针治疗眼外肌麻痹的疗效。方法:选取眼外肌麻痹患者82例,依照随机数字表法分为对照组和试验组,每组41例。对照组予以药物治疗结合针刺,试验组予以药物治疗结合杵针,两组均连续治疗7d为1个疗程,共4个疗程。比较两组治疗4个疗程后临床疗效,治疗前(T_(0))、治疗2、4个疗程后(分别为T_(1)、T_(2))视觉模拟评分(VAS)、视功能相关生活质量量表(NEI-VFQ-25)评分以及T_(0)、T_(2)时主要症状得分。结果:试验组的临床总有效率(97.56%)较对照组(82.93%)升高(P<0.05)。组内与T_(0)比较,两组T_(1)、T_(2)时VAS评分均降低(P<0.01),NEI-VFQ-25评分均升高(P<0.01);与T_(1)比较,两组T_(2)时VAS评分则降低(P<0.01),NEI-VFQ-25评分升高(P<0.01)。与对照组比较,试验组T_(1)、T_(2)时VAS评分均降低(P<0.01),NEI-VFQ-25评分均升高(P<0.01)。与T_(0)比较,两组在T_(2)时复视、眼斜、头晕、恶心及代偿头位评分均降低(P<0.01),与对照组比较,试验组在T_(2)时复视、眼斜、头晕、恶心及代偿头位评分均降低(P<0.01)。结论:杵针治疗眼外肌麻痹,可有效改善患者主要症状并降低其症状的严重程度,提高其视功能相关生活质量。

226例后天性眼外肌麻痹病因分析

目的对后天性眼外肌麻痹进行病因分析。方法回顾性分析2017年3月至2022年3月首诊收住我院的226例眼外肌麻痹患者临床资料,对其病因进行分析。结果在226例患者中121例(53.5%)神经源性,42例(18.6%)血管性疾病,26例(11.5%)肌源性。后天性眼外肌麻痹病因中前三位的疾病分别是糖尿性58例,脑梗死21例,甲状腺疾病19例。所有神经源性病例中,以动眼神经麻痹最多见,其次是外展神经,滑车神经最为少见。结论后天性眼外肌麻痹病因复杂,本研究中后天性眼外肌麻痹的前三位主要病因分别为糖尿病、脑梗死和甲状腺疾病。

A型肉毒毒素与眼外肌手术治疗大角度急性共同性内斜视的疗效对比

目的:探讨A型肉毒毒素(BTA)注射和眼外肌手术治疗大角度(≥+60 PD)急性共同性内斜视(AACE)的疗效差异性。方法:回顾性分析2020-06/2022-12于我院治疗的AACE患者60例的临床资料,根据治疗方式分为2.5 IU BTA注射组(14例)、5.0 IU BTA注射组(29例)、手术组(17例)。治疗后随访6 mo,观察纳入患者屈光矫正后的斜视度、视功能、治疗有效率及BTA注射后并发症发生情况。结果:治疗后6 mo,手术组和5.0 IU BTA注射组患者的斜视度均小于2.5 IU BTA注射组(P<0.017),但手术组与5.0 IU BTA注射组患者的斜视度无显著差异(P>0.017);5.0 IU BTA注射组有效率高于2.5 IU BTA注射组(86%vs 43%,P<0.017);三组患者各级视功能均无差异(P>0.05);2.5 IU BTA注射组和5.0 IU BTA注射组治疗后并发症总发生率无显著差异(43%vs 52%,P>0.05)。结论:对于斜视度≥+60 PD的AACE患者,双眼内直肌注射5.0 IU BTA可以取得与传统眼外肌手术相当的效果,且其具有创伤小,操作简单方便的优势。

动态对比增强MRI在甲状腺相关性眼病眼外肌微循环及活动性分期中的评估价值

目的 探讨动态对比增强磁共振成像(dynamiccontrast-enhancedMRI,DCE-MRI)技术在甲状腺相关性眼病(thyroid-associated ophthalmopathy, TAO)临床活动性分期中的价值。材料与方法 前瞻性纳入TAO患者56例,其中活动期组(37例,74只眼),非活动期组(19例,38只眼)。计算并比较两组间眼外肌的半定量参数[达峰时间(time to peak, TTP)、时间-信号强度曲线下面积(area under the time-signal intensity curve, AUC)和时间-信号强度曲线最大斜率值(maximum enhancement slope, Slope_(max))]以及定量参数[容积转运常数(volume transfer constant, K^(trans))、反流速率常数(the rate constant, Kep)和血管外细胞外间隙容积分数(fractional volume of the extravascular-extracellular space, V_(e))]的最小值、平均值和最大值。采用多因素logistic回归筛选TAO活动性分期的独立影响因素。采用受试者工作特征(receiver operating characteristic, ROC)曲线分析显著差异参数及其联合模型在TAO分期中的效能。结果 活动期组眼外肌的TTP均值、AUC最大值、AUC均值、V_(e)最大值和V_(e)均值均高于非活动期组(P<0.05)。AUC最大值和V_(e)均值是TAO活动性分期的独立影响因素(AUC最大值,P=0.030;V_(e)均值,P=0.014)。采用AUC最大值和V_(e)均值预测活动期TAO的ROC曲线下面积分别为0.689和0.673。联合AUC最大值和V_(e)均值可进一步提高对TAO活动性分期的诊断效能(ROC曲线下面积0.731)。结论 眼外肌DCE-MRI半定量和定量参数均可辅助TAO活动性分期。联合AUC最大值和V_(e)均值可以有效评估TAO活动性分期。