Quantitative Analysis of Orbital Soft Tissues Using Three-Dimensional Fast Spin Echo With 2-Point Dixon-Based Fat Suppression Sequence: Its Association With Methylprednisolone Pulse Therapy Treatment Efficacy in Thyroid-Associated Ophthalmopathy

IF 3.5 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2025-03-29 DOI:10.1002/jmri.29735

Yu Chen MBBS, Linhan Zhai MS, Weiqiang Liang MS, Yangyang Yin MBBS, Yali Zhao MS, Gang Yuan MD, Ban Luo MS, Haoyue Shao MS, Wang Baoyi MS, Qiuxia Wang MD, Jing Zhang MD, PhD

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Abstract

Background

Three-dimensional fast spin echo with 2-point Dixon-based fat suppression (3D-FSE-Dixon) sequence may assess volume and water fraction (WF) of orbit.

Purpose

To explore the association between 3D-FSE-Dixon based parameters and methylprednisolone pulse therapy (MPPT) efficacy in active moderate-to-severe thyroid-associated ophthalmopathy (TAO).

Study Type

Retrospective.

Population

Fifty-nine TAO patients (29 females, 30 males, 49.1 ± 10.9 years) were included: 26 (15 females, 11 males, 48.4 ± 11.1 years) showed improvement and 33 (14 females, 19 males, 49.6 ± 10.9 years) did not.

Field Strength/Sequence

3D-FSE-Dixon sequence of orbits at 3 T.

Assessment

Manual segmentation delineated bony orbit (BO), whole orbit (WO), globe (GO), lacrimal gland (LG), and optic nerve (ON). Multi-dimensional threshold (MDT) identified orbital fat (OF). Extraocular muscles (ETM) were obtained by subtracting other tissues from WO. WF was calculated from water and in-phase images. Treatment efficacy, the clinical outcome, was assessed within 2 weeks after MPPT.

Statistical Tests

Unpaired t-test and Mann–Whitney U test compared normal and non-normal data, respectively. Paired t-test analyzed parameter changes pre- and post-MPPT. Multivariate logistic regression analysis identified factors independently associated with the efficacy of MPPT. Significance was set at P < 0.05.

Results

Responsive group showed significantly higher pre-treatment WF (ETM, 0.86 ± 0.06 vs. 0.82 ± 0.07; OF, 0.21 ± 0.04 vs. 0.19 ± 0.02), with no difference in volume (OF: 21.34 ± 3.33 vs. 21.36 ± 3.46, P = 1.00; ETM: 13.48 ± 2.82 vs. 13.72 ± 3.45, P = 1.00) or volume ratio (OF/GO: 3.23 ± 0.50 vs. 3.26 ± 0.56, P = 1.00; ETM/GO: 2.06 ± 0.58 vs. 2.12 ± 0.64, P = 1.00). WF significantly decreased in responsive group (ETM, 0.86 ± 0.06 vs. 0.79 ± 0.05; OF, 0.21 ± 0.04 vs. 0.17 ± 0.03) but not decreased in unresponsive group (ETM, 0.81 ± 0.07 vs. 0.81 ± 0.07, P = 1.00; OF, 0.19 ± 0.02 vs. 0.190 ± 0.02, P = 1.00). ETM WF and disease duration can assess MPPT efficacy.

Data Conclusion

Higher ETM WF demonstrates better MPPT efficacy for TAO.

Evidence Level

Technical Efficacy

Stage 4

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基于2点dixon脂肪抑制序列的三维快速自旋回波眼眶软组织定量分析：与甲基强的松龙脉冲治疗甲状腺相关性眼病疗效的关系

背景：基于2点dixon脂肪抑制（3D-FSE-Dixon）序列的三维快速自旋回波可以评估轨道的体积和水分数（WF）。目的：探讨3D-FSE-Dixon参数与甲基强的松龙脉冲治疗（MPPT）治疗活动性中重度甲状腺相关性眼病（TAO）疗效的关系。研究类型：回顾性。人群：纳入TAO患者59例（女性29例，男性30例，49.1±10.9岁），其中26例（女性15例，男性11例，48.4±11.1岁）好转，33例（女性14例，男性19例，49.6±10.9岁）无好转。场强/序列：3t轨道的3D-FSE-Dixon序列。评估：人工分割划定骨眶（BO）、全眶（WO）、眶（GO）、泪腺（LG）和视神经（ON）。多维阈值（MDT）识别眶脂肪（OF）。眼外肌（ETM）由眼窝组织减去其他组织得到。WF由水和同相图像计算。治疗效果，临床结果，在MPPT后2周内评估。统计检验：非配对t检验和Mann-Whitney U检验分别比较正态和非正态数据。配对t检验分析mppt前后的参数变化。多因素logistic回归分析确定了与MPPT疗效独立相关的因素。结果：反应组治疗前WF （ETM）显著高于治疗前，分别为0.86±0.06∶0.82±0.07；的,0.21±0.04和0.19±0.02),没有区别的卷(:21.34±3.33和21.36±3.46,P = 1.00;ETM: 13.48±2.82和13.72±3.45,P = 1.00)或体积比(的/去:3.23±0.50和3.26±0.56,P = 1.00;ETM/GO: 2.06±0.58 vs. 2.12±0.64,P = 1.00)。反应组WF显著降低(ETM, 0.86±0.06 vs. 0.79±0.05；OF, 0.21±0.04比0.17±0.03)，无反应组未降低(ETM, 0.81±0.07比0.81±0.07,P = 1.00；OF（0.19±0.02比0.190±0.02,P = 1.00）。ETM、WF和病程可以评价MPPT的疗效。数据结论：ETM WF越高，MPPT治疗TAO的疗效越好。证据等级：4技术功效：4期。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.