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Fractional anisotropy and diffusivity changes in thyroid-associated orbitopathy.

Ji Sung Han1, Hyung Suk Seo2, Young Hen Lee1

  • 1Department of Radiology, Korea University Ansan Hospital, Jeokgum-ro 123, Gojan-dong, Ansan, Gyeonggido, 15355, South Korea.

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Summary

Diffusion Tensor Imaging (DTI) reveals extraocular muscle changes in thyroid-associated orbitopathy (TAO). DTI parameters like FA and radial diffusivity can diagnose TAO and differentiate acute from chronic stages.

Keywords:
Diffusion tensor imagingExtraocular muscleMRIThyroid associated orbitopathy

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Area of Science:

  • Ophthalmology
  • Radiology
  • Medical Imaging

Background:

  • Thyroid-associated orbitopathy (TAO) involves extraocular muscle (EOM) changes.
  • Understanding these EOM changes is crucial for TAO diagnosis and management.
  • Diffusion Tensor Imaging (DTI) offers a novel approach to assess EOM microstructure.

Purpose of the Study:

  • To investigate EOM changes in TAO using DTI.
  • To correlate DTI parameters with clinical features of TAO, including muscle thickness and disease stage.
  • To evaluate DTI's utility in diagnosing TAO and differentiating disease phases.

Main Methods:

  • Twenty TAO patients and 20 controls underwent ten-directional DTI.
  • Fractional anisotropy (FA) and diffusivities (mean, axial, radial) were measured in medial and lateral EOMs.
  • EOM thickness, clinical activity, and disease duration were assessed and correlated with DTI findings.

Main Results:

  • Medial EOM showed significantly lower FA and higher radial diffusivity in TAO patients, correlating with muscle thickness.
  • Lateral EOM DTI values did not differ significantly between patients and controls.
  • Increased medial rectus EOM diffusivities were observed in the acute stage compared to the chronic stage.

Conclusions:

  • DTI, specifically FA and radial diffusivity changes in EOM, can aid in TAO diagnosis.
  • DTI-derived diffusivities can help differentiate between acute and chronic TAO.
  • DTI showed limitations in reflecting TAO activity based on the Clinical Activity Score (CAS).