Page 106 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第4期
·556 · Journal of Nanjing Medical University（Natural Sciences） 2022年4月

·临床研究·

Dixon技术在甲状腺相关性眼病早期视神经改变评估中的价值

高 松，陈 露，胡 昊，许晓泉，秦 朗 ，吴飞云
*
南京医科大学第一附属医院放射科，江苏 南京 210029

［摘 要］ 目的：探讨 Dixon 技术在甲状腺相关性眼病（thyroid⁃associated ophthalmopathy，TAO）早期视神经改变评估中的价
值。方法：回顾性分析28例TAO患者和15例健康志愿者的临床和影像学资料。测量并比较两组视神经信号强度比值（signal
intensity ratio，SIR）、视神经含水量（water fraction，WF）以及视力的差异。采用Spearman’s相关分析评估病例组视神经SIR、WF
值与临床参数的相关性。使用受试者工作特征曲线评估视神经SIR、WF值鉴别TAO与健康对照组视神经的效能。结果：TAO
组视力显著低于对照组（P = 0.024），视神经SIR值和WF值均显著高于对照组（P = 0.008；P = 0.003）。TAO组视神经SIR值和
WF值均与临床活动度评分呈正相关（r = 0.369，P = 0.005；r = 0.420，P = 0.001）。以WF值 > 0.914为阈值判断视神经异常，可
获得最优的鉴别效能及特异度（曲线下面积=0.694，敏感度35.7%，特异度93.3%）。联合WF值 > 0.914和SIR值 > 1.903判断视
神经异常，鉴别效能及敏感度进一步提高（曲线下面积=0.729，敏感度 75.0%，特异度 63.3%）。结论：Dixon 技术可用于评估
TAO早期视神经改变。
［关键词］ Dixon；甲状腺相关性眼病；视神经；磁共振成像
［中图分类号］ R581.9 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）04⁃556⁃05
doi：10.7655/NYDXBNS20220415

The value of Dixon in the evaluation of early optic nerve changes in patients with thyroid⁃
associated ophthalmopathy

*
GAO Song，CHEN Lu，HU Hao，XU Xiaoquan，QIN Lang ，WU Feiyun
Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To detect the value of Dixon in evaluating early optic nerve changes in the patients with thyroid⁃associated
ophthalmopathy（TAO）. Methods：The clinical and imaging data of 28 consecutive TAO patients and 15 healthy controls were
retrospectively analyzed. Signal intensity ratio（SIR），water fraction（WF）of optic nerve and visual acuity were collected and compared
between TAO and healthy groups. The correlations between the SIR and WF value of optic nerve and clinical indicators were analyzed
using Spearman’s correlation analysis. Receiver operating characteristic curve analysis was applied to assess the discriminating
performance of SIR and WF value. Results：TAO group had significantly lower visual acuity and higher SIR and WF values of optic
nerve than those of healthy group（P < 0.05）. SIR and WF value of optic nerve correlated positively with clinical activity score（r = 0.369，
P=0.005；r=0.420，P=0.001）. Setting a cut⁃off WF value of 0.914 enabled optimal efficiency and specificity for discriminating optic
nerves between TAOs and HCs（area under curve，0.694；sensitivity，35.7%；specificity，93.3%）. Combining SIR and WF values of
optic nerves，discriminating efficiency and sensitivity were further improved（area under curve，0.729；sensitivity，75.0%；specificity，
63.3%）. Conclusion：Dixon technique is suggested to be used in the evaluation of early optic nerve changes in TAO patients.
［Key words］ Dixon；thyroid⁃associated ophthalmopathy；optic nerve；magnetic resonance imaging
［J Nanjing Med Univ，2022，42（04）：556⁃559，577］

甲状腺相关眼病（thyroid⁃associated ophthalmop⁃
［基金项目］ 国家自然科学基金青年项目（81801659） athy，TAO）可导致视神经功能改变，引起甲状腺相
关视神经病变（dysthyroid optic neuropathy，DON），部
∗
通信作者（Corresponding author），E⁃mail：qinlang09820206@
［1］
163.com 分重症者可致永久性失明 。口服和静脉注射糖皮