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T2 mapping MRI评估甲状腺相关性眼病免疫抑制疗效的初步研究

姜虹  燕飞  鲜军舫  艾立坤  王雪   

  1. 100730 首都医科大学附属北京同仁医院,放射科(姜虹、燕飞、鲜军舫),眼科(艾立坤),内分泌科(王雪)
  • 收稿日期:2018-02-08 出版日期:2018-09-25 发布日期:2018-09-18
  • 通讯作者: 燕飞,Email: yanever@163.com

T2 mapping MRI study on immunosuppression therapy of thyroid associated ophthalmopathy

 JIANG Hong1, YAN Fei1, XIAN Jun-fang1, AI Li-kun2, WANG Xue3   

  1. 1. Department of Radiology, 2. Department of Ophthalmology, 3. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2018-02-08 Online:2018-09-25 Published:2018-09-18
  • Contact: YAN Fei, Email: yanever@163.com

摘要:

目的 探讨T2 mapping MRI评估甲状腺相关性眼病(TAO)免疫抑制疗效的价值。设计 前瞻性病例系列。研究对象 74 例经免疫抑制治疗的TAO患者。方法 全部患者行冠状面 T2 mapping MRI成像,对图像进行分析。根据患者主要症状、体征及眼外肌功能的改善情况,将免疫抑制治疗效果分为有效和无效,有效分为极好、很好、一般,无效分为无变化、恶化。主要指标 双侧各条眼外肌的T2值,不同疗效患者治疗前maxT2值及治疗前后maxT2变化值。结果 免疫抑制疗效极好者18例,很好者13例,一般者11例,无变化者30例,恶化者2例。有效组治疗前maxT2显著大于无效组(P<0.001),治疗后maxT2显著降低(P<0.001),且治疗效果越好,maxT2变化值越大。治疗前maxT2与治疗后maxT2变化值呈显著线性负相关(r=0.643,P<0.0001)。结论 眼外肌T2 mapping MRI有助于评估TAO免疫抑制疗效。(眼科, 2018, 27: 339-343)

关键词: 甲状腺相关性眼病, T2 mapping磁共振成像, 免疫抑制治疗

Abstract:

Objective To evaluate the value of T2 mapping MRI in evaluating immunosuppression therapy of thyroid associated  ophthalmopathy (TAO). Design Prospective case series. Participants 74 TAO patients with immunosuppression therapy. Method Coronal T2 mapping MRI was performed. According to the changes of main symptoms, sign and extraocular muscles (EOMs) function, the outcomes of immunosuppression therapy were divided into effectiveness and non-effectiveness. Effectiveness included excellent, well and general cases. Non-effectiveness included unchanged and deterioration cases. Main Outcome Measures T2 values of EOMs and the maxT2 changes. Results The treatment effect was excellent, well, general, unchanged and deteriorated in 18, 13, 11, 30 and 2 cases respectively. The maxT2 was significantly higher in effective group than in non-effective group (P<0.001). MaxT2 value decreased significantly after treatment (P<0.001). Correlation analysis revealed negative correlation between maxT2 and changes of maxT2 after therapy (r=0.643, P<0.0001). Conclusions T2 mapping MRI is valuable in evaluation of TAO immunosuppression therapy effect. (Ophthalmol CHN, 2018, 27: 339-343)

Key words: thyroid associated ophthalmopathy, T2 mapping magnetic resonance imaging, immunosuppression therapy