[Magnetic resonance tomographic differentiation of ocular muscle changes in endocrine orbitopathy]

In 50 patients with Graves' Ophthalmopathy and 9 controls both orbits were examined by MR Imaging at 0.5 Tesla using a surface coil. T1-weighted spin-echo images were obtained in transverse and coronal orientation; additionally, a T2-image was calculated from a multi-echo sequence (8 echoes). Signal intensity of eye muscles on both T1-weighted and T2-weighted MR images was evaluated qualitatively. T2-times were then calculated for all inferior rectus muscles. Eye muscle enlargement was found in 28 out of 50 patients. T2-times of inferior rectus muscles in stage III and IV patients were evaluated significantly (p less than 0.05). Areas of high signal intensity were accordingly found in enlarged eye muscles in 19 out of 50 patients; they were interpreted as edematous tissue changes. Areas of low signal intensity were found in enlarged eye muscles of 5 out of 50 patients; these eye muscles were considered fibrotic. Differentiation of eye muscle changes by MR imaging might help to decide between antiinflammatory medication and surgical therapy in patients with Graves' Ophthalmopathy.