Therapeutic effect of using pulse treatment of glucocorticoidin on thyroid ⁃ associated ophthalmopathy evaluated by quantitative ocular muscle structure measurement of MRI
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摘要:
目的：评估甲状腺相关眼病（thyroid-associated ophthalmopathy，TAO）在糖皮质激素脉冲治疗后眼部各参数的变化，初步探讨MRI眼肌结构量化评估在糖皮质激素脉冲治疗TAO疗效评估中的价值。方法：对18例活动性TAO病例在甲基强的松龙治疗前后分别行3.0 T MR眼眶扫描，分别测量眼球突出度、眼球内侧脂肪厚度、最高信号强度眼外肌厚度、眼外肌最高信号强度与同侧颞肌最高信号强度的信号强度比（signal intensity ratio，SIR）。通过配对t检验对比甲基强的松龙治疗前后各参数的变化。结果：标准化糖皮质激素脉冲治疗后，患者突眼度、眼眶内侧脂肪厚度下降不明显；但眼外肌/颞肌SIR、最高信号强度眼外肌厚度、临床活动性评分（clinical active score，CAS）明显下降。结论：糖皮质激素治疗可降低TAO患者眼外肌/颞肌SIR和眼外肌厚度，MRI眼肌结构量化评估技术可辅助TAO的疗效评估。
Abstract:
Objective：To assess the changes of ocular parameters and to evaluate the therapeutic effect after pulse treatment of glucocorticoid in patients with thyroid-associated ophthalmopathy（TAO） based on quantitative ocular muscle structure measurement of MRI. Methods：Eighteen TAO patients were enrolled for 3.0 T MRI orbit scan before and after methylprednisolone treatment. Quantitative measurement of orbital structures including exophthalmos values，fatty tissue thickness of inner side in eye balls，thickness of extraocular muscles with maximum signal intensity and signal intensity ratios（SIR）of extraocular muscles to ipsilateral temporal muscles were compared before and after treatment. Paired t test was used to compare changes of parameters before and after methylprednisolone pulse treatment. Results：After treatment of classical methylprednisolone，exophthalmos values and fatty tissue thickness of inner side in eye balls didin’t obviously changed，while SIR of extraocular muscles to ipsilateral temporal muscles，thickness of extraocular muscles with maximum signal intensity and CAS score decreased significantly. Conclusion：Glucocorticoid therapy can reduce SIR of extraocular muscles to ipsilateral temporal muscles，thickness of extraocular muscles with maximum signal intensity in TAO patients. MRI quantitative ocular muscle measurement can evaluate glucocorticoid treatment on TAO.
