[Current imaging methods in Graves' ophthalmopathy]

Imaging of the extraocular muscles and orbital soft tissues in Graves' orbitopathy provides valuable information for both diagnosis and treatment decisions. However, assessment of the activity of the autoimmune process is often difficult. Currently available scoring systems for activity estimation are based merely on complaints and physical and ophthalmological examination. A reliable laboratory parameter correlating with disease activity is also missing. Sonography and magnetic resonance studies have pointed out, that thickening and/or edema of the extraocular muscles are often present before the onset of clinical symptoms and complaints. MRI and scintigraphy may provide important information upon the activity of the orbital process. Since the disease progrediates in the absence of therapy, it is essential to launch a properly timed immunosuppressive treatment in a selected group of patients. Based on their long-term experience in the Medical and Health Science Center of the University of Debrecen, Hungary, the authors review the currently available imaging methods in the diagnosis and follow up of endocrine orbitopathy, emphasizing their advantages and drawbacks.