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Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using

Huan Huan Chen1, Hao Hu2, Wen Chen2

  • 1Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Korean Journal of Radiology
|February 25, 2020
PubMed
Summary

Readout-segmented echo-planar imaging-based diffusion tensor imaging (rs-EPI-DTI) effectively detects microstructural changes in extraocular muscles and optic nerves in thyroid-associated orbitopathy (TAO). This technique aids in evaluating TAO disease activity, particularly using medial EOM mean diffusivity.

Keywords:
Diffusion tensor imagingExtraocular muscleOptic nerveReadout-segmented echo-planar imagingThyroid-associated orbitopathy

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Area of Science:

  • Neuroimaging
  • Ophthalmology
  • Radiology

Background:

  • Thyroid-associated orbitopathy (TAO) involves microstructural changes in extraocular muscles (EOMs) and optic nerves.
  • Accurate assessment of these changes and disease activity is crucial for effective management.
  • Diffusion tensor imaging (DTI) offers a non-invasive method to evaluate tissue microstructure.

Purpose of the Study:

  • To investigate the utility of readout-segmented echo-planar imaging (rs-EPI)-based DTI in assessing EOM and optic nerve microstructural alterations in TAO patients.
  • To evaluate the capability of rs-EPI-DTI in differentiating between active and inactive TAO.
  • To identify imaging biomarkers predictive of TAO disease activity.

Main Methods:

  • 35 TAO patients and 22 healthy controls (HCs) underwent pre-treatment rs-EPI-based DTI.
  • Diffusion parameters including mean, axial, and radial diffusivity (MD, AD, RD) and fractional anisotropy (FA) were calculated for medial and lateral EOMs and optic nerves.
  • Statistical comparisons were made between TAO and HC groups, and between active and inactive TAO subgroups. Logistic regression was employed to assess predictive values for disease activity.

Main Results:

  • TAO patients exhibited significantly altered DTI parameters in EOMs and optic nerves compared to HCs.
  • Active TAO cases showed distinct DTI changes in medial EOMs (higher FA, MD, AD) and lateral EOMs (different FA) compared to inactive cases.
  • Mean diffusivity (MD) of medial EOMs and disease duration emerged as significant predictors of TAO disease activity, with combined optimal diagnostic efficiency (AUC=0.855).

Conclusions:

  • rs-EPI-based DTI is a promising technique for characterizing microstructural changes in EOMs and optic nerves in TAO.
  • This imaging modality can effectively indicate TAO disease activity.
  • Medial EOM MD, in conjunction with disease duration, demonstrates significant potential for predicting disease activity in TAO.