The British journal of radiology · 2026
Pilot study using synthetic MRI for determining the disease activity of thyroid-associated ophthalmopathy.
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Wan Ying, Lu Jin-Ling, Zhou Jiang, Zhou Yu-Hui, Qin Jia-Ting, Chen Huan-Huan, Wu Fei-Yun, Xu Xiao-Quan, Hu Hao
Аннотация
OBJECTIVES: To investigate the value of synthetic MRI (SyMRI) of extraocular muscles (EOMs) in determining the disease activity of thyroid-associated ophthalmopathy (TAO).
METHODS: Seventy-seven patients with TAO (31 active; 46 inactive) were prospectively enrolled. Orbital SyMRI was performed and post-processed to generate quantitative maps (T1 map, T2 map, and proton density [PD] map) and contrast-weighted images (double inversion recovery [DIR], short inversion recovery [STIR], and fluid-attenuated inversion recovery [FLAIR]). Maximum, mean, and minimum values of PD, T1 relaxation time (T1RT), and T2 relaxation time (T2RT) of EOMs, and the signal intensity ratio (SIR) of contrast-weighted images were calculated and compared between 2 groups. Multivariate logistic regression identified independent predictors of disease activity. Receiver operating characteristic curve analyses and DeLong tests evaluated and compared the diagnostic performance of significant parameters and combined models.
RESULTS: Active TAO patients had higher values of both quantitative and semi-quantitative parameters than inactive patients, except for FLAIR-Min (all P < .05). DIR-Mean, PD-Mean, T1RT-Mean, and T2RT-Mean of EOMs were independently associated with active TAO (all P < .05). The combined model integrating 4 independent predictors showed higher diagnostic performance (AUC, 0.884; specificity, 89.13%; sensitivity, 77.42%) than DIR-Mean (AUC = 0.802), PD-Mean (AUC = 0.818), T1RT-Mean (AUC = 0.835), or T2RT-Mean (AUC = 0.824) alone in distinguishing active from inactive patients (all P < .05).
CONCLUSIONS: SyMRI might be one promising imaging modality for determining the disease activity of TAO.
ADVANCES IN KNOWLEDGE: SyMRI quantifies PD, T1RT, and T2RT in a single scan with clinically acceptable time. Our study innovatively synthesized multiple contrast-weighted images, improving the efficacy of TAO staging.
METHODS: Seventy-seven patients with TAO (31 active; 46 inactive) were prospectively enrolled. Orbital SyMRI was performed and post-processed to generate quantitative maps (T1 map, T2 map, and proton density [PD] map) and contrast-weighted images (double inversion recovery [DIR], short inversion recovery [STIR], and fluid-attenuated inversion recovery [FLAIR]). Maximum, mean, and minimum values of PD, T1 relaxation time (T1RT), and T2 relaxation time (T2RT) of EOMs, and the signal intensity ratio (SIR) of contrast-weighted images were calculated and compared between 2 groups. Multivariate logistic regression identified independent predictors of disease activity. Receiver operating characteristic curve analyses and DeLong tests evaluated and compared the diagnostic performance of significant parameters and combined models.
RESULTS: Active TAO patients had higher values of both quantitative and semi-quantitative parameters than inactive patients, except for FLAIR-Min (all P < .05). DIR-Mean, PD-Mean, T1RT-Mean, and T2RT-Mean of EOMs were independently associated with active TAO (all P < .05). The combined model integrating 4 independent predictors showed higher diagnostic performance (AUC, 0.884; specificity, 89.13%; sensitivity, 77.42%) than DIR-Mean (AUC = 0.802), PD-Mean (AUC = 0.818), T1RT-Mean (AUC = 0.835), or T2RT-Mean (AUC = 0.824) alone in distinguishing active from inactive patients (all P < .05).
CONCLUSIONS: SyMRI might be one promising imaging modality for determining the disease activity of TAO.
ADVANCES IN KNOWLEDGE: SyMRI quantifies PD, T1RT, and T2RT in a single scan with clinically acceptable time. Our study innovatively synthesized multiple contrast-weighted images, improving the efficacy of TAO staging.