Abstract:
PURPOSE:We aimed to evaluate the performance of structural magnetic resonance imaging (MRI)-based quantitative measurements at extraocular muscle (EOM), orbital fat (OF), and especially lacrimal gland (LG) in predicting response to glucocorticoid (GC) in patients with active and moderate-severe thyroid-associated ophthalmopathy (TAO). METHODS:Forty-seven active and moderate-severe TAOs (responsive group, 29 patients and 58 eyes; unresponsive group, 18 patients and 36 eyes) were enrolled. Pretreatment MRI-based parameters of EOM, OF, and LG, and clinical factors were retrospectively collected and compared between two groups. Logistic regression and receiver operating characteristic curve analyses were used to assess the predictive value of identified independent variables. RESULTS:Responsive group showed significantly higher minimum signal intensity ratio of EOM (EOM-SIRmin) (p < 0.001), higher EOM-SIRmean (p = 0.034), higher LG herniation (LGH) (p = 0.019), lower OF thickness (OFT) (p = 0.017), higher LGH/OFT ratio (p = 0.001), and shorter disease duration (p = 0.004) than unresponsive group. Multivariate analysis showed that EOM-SIRmin, LGH/OFT ratio, and disease duration were independent predictors for responsive TAOs (all p < 0.05). Integration of three independent predictors demonstrated optimal predictive efficiency (area under curve, 0.829). Combining EOM-SIRmin ≥1.43 and LGH/OFT ratio ≥1.65, optimal predictive specificity (94.4%) could be obtained, while optimal predictive sensitivity (82.8%) was achieved when integrating disease duration ≤3.5 and LGH/OFT ratio ≥1.65. CONCLUSIONS:Structural MRI-based quantitative measurements at EOM, OF, and LG, specially EOM-SIRmin and LGH/OFT ratio, together with disease duration, may serve as promising markers to predict response to GC in patients with active and moderate-severe TAO.
journal_name
Endocrinejournal_title
Endocrineauthors
Hu H,Xu XQ,Chen L,Chen W,Wu Q,Chen HH,Zhu H,Shi HB,Wu FYdoi
10.1007/s12020-020-02367-5subject
Has Abstractpub_date
2020-11-01 00:00:00pages
372-379issue
2eissn
1355-008Xissn
1559-0100pii
10.1007/s12020-020-02367-5journal_volume
70pub_type
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