MR高清扩散张量成像在甲状腺相关性眼病视神经病变的相关研究The study of high-resolution diffusion tensor imaging in thyroid-associated ophthalmopathy
张小辉;张志伟;吕发金;刘存;龙建;郁斌;李咏梅;
摘要(Abstract)：
目的研究MR高清扩散张量成像技术在甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)患者早期视神经微结构损伤的应用。材料与方法收集临床确诊的无明显视神经病变的TAO患者及年龄与性别相匹配的健康志愿者(healthy controls,HC)各30例,分别进行眼眶常规MRI序列扫描及Resolve DTI序列扫描,分别测量双侧视神经的部分各向异性分数(fractional anisotropy,FA),表观扩散系数(apparent diffusion coefficient,ADC),轴向扩散率(axial diffusivity,AD),径向扩散率(radial diffusivity,RD)值,比较患者与健康志愿者之间双侧视神经各DTI相关定量参数值的差异。结果 TAO患者的双侧视神经的FA值明显小于健康对照组(P=0.009,P=0.003;P<0.05),ADC及AD值差异无统计学意义(P=0.364,P=0.053,P=0.955,P=0.211;P>0.05),RD值高于正常对照组(P=0.010,P=0.009;P<0.05)。结论 Resolve DTI技术有助于为TAO患者早期视神经微结构的损伤提供客观依据,对TAO患者视神经病变的治疗提供帮助。
关键词(KeyWords)： 甲状腺相关性眼病;视神经;分段读取扩散张量成像;部分各向异性分数;表观扩散系数
基金项目(Foundation): 国家重点研发计划(编号：2016YFC0107109);; 重庆市卫计委医学科研青年项目(编号：2018QNXM004);; 重庆市科卫联合医学科研项目(编号：2020MSXM119)~~
作者(Authors): 张小辉;张志伟;吕发金;刘存;龙建;郁斌;李咏梅;
参考文献(References)：
- [1]Wang FF,Cheng JL,Zhang Y,et al.Application of MR high-definition resolution readout segmentation of long variable echo-trains diffusion weighted imaging in the diagnosis of thyroid associated ophthalmopathy[J].Int Eye Sci,2020,20(12):2129-2133.王斐斐,程敬亮,张焱,等.MR高清扩散加权成像在甲状腺相关性眼病诊断中的应用[J].国际眼科杂志,2020,20(12):2129-2133.
- [2]Goncalves AC,Gebrim EM,Monteiro ML.Imaging studies for diagnosing Graves'orbitopathy and dysthyroid optic neuropathy[J].Clinics (Sao Paulo),2012,67(11):1327-1334.DOI:10.6061/clinics/2012(11)18.
- [3]Chen HH,Hu H,Chen W,et al.Thyroid-associated orbitopathy:evaluating microstructural changes of extraocular muscles and optic nerves using readout-segmented echo-planar imaging-based diffusion tensor imaging[J].Korean J Radiol,2020,21(3):332-340.DOI:10.3348/kjr.2019.0053.
- [4]Dolmann PJ.Evaluating Graves'orbitopathy[J].Best Pract Res Clin Endocrinol Metab,2012,26(3):229-248.DOI:10.1016/j.beem.2011.11.007.
- [5]Min J,Park M,Choi JW,et al.Inter-vendor and inter-session reliability of diffusion tensor imaging:implications for multicenter clinical imaging studies[J].Korean J Radiol,2018,19(4):777-782.DOI:10.3348/kjr.2018.19.4.777.
- [6]Wang MY,Wu K,Xu JM,et al.Quantitative 3-T diffusion tensor imaging in detecting optic nerve degeneration in patients with glaucoma:association with retinal nerve fiber layer thickness and clinical severity[J].Neuroradiology,2013,55(4):493-498.DOI:10.1007/s00234-013-1133-1.
- [7]Han JS,Seo HS,Lee YH,et al.Fractional anisotropy and diffusivity changes in thyroid associated orbitopathy[J].Neuroradiology,2016,58(12):1189-1196.DOI:10.1007/s00234-016-1764-0.
- [8]Lee H,Lee YH,Suh SI,et al.Characterizing intraorbital optic nerve changes on diffusion tensor imaging in thyroid eye disease before dysthyroid optic neuropathy[J].J Comput Assist Tomogr,2018,42(2):293-298.DOI:10.1097/RCT.0000000000000680.
- [9]Politi LS,Godi C,Cammarata G,et al.Magnetic resonance imaging with diffusion weighted imaging in the evaluation of thyroid-associated orbitopathy:getting below the tip of the iceberg[J].Eur Radiol,2014,24(5):1118-1126.DOI:10.1007/s00330-014-3103-3.
- [10]?zkan B,Anik Y,Katre B,et al.Quantitative assessment of optic nerve with diffusion tensor imaging in patients with thyroid orbitopathy[J].Ophthal Plast Reconstr Surg,2015,31(5):391-395.DOI:10.1097/IOP.0000000000000359.
- [11]Nucci C,Mancino R,Martucci A,et al.3-T Diffusion tensor imag ing of the optic nerve in subjects with glaucoma:correlation with GDx-VCC,HRT-III and Stratus optical coherence tomography findings[J].Br JOphthalmol,2012,96(7):976-980.DOI:10.1136/bjophthalmol-2011-301280.
- [12]Anik I,An?k Y,Ko?K,et al.Evaluation of early visual recovery in pituitary macroadenomas after endoscopic endonasal transsphenoi dal surgery:quantitative assessment with diffusion tensor imaging(DTI)[J].Acta Neurochir,2011,153(4):831-842.DOI:10.1007/s00701-011-0942-4.
- [13]Sun SW,Liang HF,Le TQ,et al.Differential sensitivity of in vivo and ex vivo diffusion tensor imaging to evolving optic nerve injury in mice with retinal ischemia[J].Neuroimage,2006,32(3):1195-1204.DOI:10.1016/j.neuroimage.2006.04.212.
- [14]Santarelli X,Garbin G,Ukmar M,et al.Dependence of the fractional anisotropy in cervical spine from the number of diffusion gradients,repeated acquisition and voxel size[J].Magn Reson Imaging,2010,28(1):70-76.DOI:10.1016/j.mri.2009.05.046.
- [15]Oouchi H,Yamada K,Sakai K,et al.Diffusion anisotropy measurement of brain white matter is affected by voxel size:underestimation occurs in areas with crossing fibers[J].AJNR Am J Neuroradiol,2007,28(6):1102-1106.DOI:10.3174/ajnr.A0488.