Three dimensional orbital magnetic resonance T2-mapping in the evaluation of patients with Graves' ophthalmopathy

J Huazhong Univ Sci Technolog Med Sci. 2017 Dec;37(6):938-942. doi: 10.1007/s11596-017-1831-8. Epub 2017 Dec 21.

Abstract

The clinical application of orbital magnetic resonance (MR) T2-mapping imaging in detecting the disease activity of Graves' ophthalmopathy (GO), and the predictive values of therapy response to intravenous glucocorticoid (ivGC) were investigated. Approved by the local institutional review board (IRB), 106 consecutive patients with GO were included in this prospective study. All subjects were divided into two groups according to the patients' clinical activity score (CAS): the CAS positive group (CAS ≥3) or the CAS negative group (CAS <3). T2 relaxation time of extraocular muscles (T2RT; ms) and the areas of four extra-ocular muscles (AEOMs; mm2) were measured by 3D T2-mapping MR sequence before and after methylprednisolone treatment, so as the CAS and some ophthalmic examinations including visual acuity, intra-ocular pressure, eyeball movement, diplopia and proptosis. In addition, 24 healthy volunteers were recruited as the control group. The mean T2RT and AEOMs in CAS positive group were higher than those in CAS negative group. Both CAS positive and negative groups had significantly higher mean T2RT and AEOMs than the control group (P<0.01). There was a positive correlation between T2RT and AEOMs values in GO patients, both of them had a positive correlation with CAS and the ophthalmic examinations. It was concluded that to evaluate the activity of GO, CAS was mostly related to inflammation symptoms of ocular surface, more than that, T2RT and AEOMs were also related to abnormal findings of the ophthalmic examinations including high ocular pressure, impaired eyeball movement, diplopia and proptosis. T2RT and AEOMs can reflex the inflammation state of ocular muscles better. CAS combined with 3D T2-mapping MR imaging could improve the sensitivity of detection of active GO so as the prediction and evaluation of the response to methylprednisolone treatment.

Keywords: Graves’ ophthalmopathy; magnetic resonance; methylprednisolone.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Case-Control Studies
  • Eye Movements
  • Female
  • Glucocorticoids / therapeutic use
  • Graves Ophthalmopathy / diagnostic imaging*
  • Graves Ophthalmopathy / drug therapy*
  • Graves Ophthalmopathy / physiopathology
  • Humans
  • Intraocular Pressure
  • Magnetic Resonance Imaging / methods*
  • Male
  • Methylprednisolone / therapeutic use*
  • Middle Aged
  • Oculomotor Muscles / diagnostic imaging*
  • Oculomotor Muscles / drug effects
  • Oculomotor Muscles / physiopathology
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Visual Acuity

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Methylprednisolone