| Autor: |
Lee MJ; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA. minjounglee77@gmail.com.; Department of Ophthalmology, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang, 14068, Republic of Korea. minjounglee77@gmail.com., Hamilton BE; Department of Radiology, Oregon Health and Science University, Portland, OR, USA., Pettersson D; Department of Radiology, Oregon Health and Science University, Portland, OR, USA., Ogle K; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Murdock J; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Dailey RA; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Ng JD; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Steele EA; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Verma R; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Planck SR; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Martin TM; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA., Choi D; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA.; Oregon Health and Science University-Portland State University School of Public Health, Oregon Health and Science University, Portland, USA.; Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.; Department of Medicine, Oregon Health and Science University, Portland, OR, USA., Rosenbaum JT; Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA.; Devers Eye Institute, Legacy Health System, Portland, OR, USA.; Department of Medicine, Oregon Health and Science University, Portland, OR, USA. |
| Abstrakt: |
Radiologic orbital imaging provides important information in the diagnosis and management of orbital inflammation. However, the diagnostic value of orbital imaging is not well elucidated. This study aimed to investigate the diagnostic accuracy of orbital imaging to diagnose orbital inflammatory diseases and its ability to detect active inflammation. We collected 75 scans of 52 patients (49 computed tomography (CT) scans; 26 magnetic resonance (MR) imaging scans). Clinical diagnoses included thyroid eye disease (TED) (41 scans, 31 patients), non-specific orbital inflammation (NSOI) (22 scans, 14 patients), sarcoidosis (4 scans, 3 patients), IgG4-related ophthalmic disease (IgG4-ROD) (5 scans, 3 patients), and granulomatosis with polyangiitis (GPA) (3 scans, 1 patient). Two experienced neuroradiologists interpreted the scans, offered a most likely diagnosis, and assessed the activity of inflammation, blinded to clinical findings. The accuracy rate of radiological diagnosis compared to each clinical diagnosis was evaluated. Sensitivity and specificity in detecting active inflammation were analyzed for TED and NSOI. The accuracy rate of radiologic diagnosis was 80.0% for IgG4-ROD, 77.3% for NSOI, and 73.2% for TED. Orbital imaging could not diagnose sarcoidosis. Orbital CT had a sensitivity of 50.0% and a specificity of 75.0% to predict active TED using clinical assessment as the gold standard. The sensitivity/specificity of orbital MR was 83.3/16.7% for the detection of active NSOI. In conclusion, orbital imaging is accurate for the diagnosis of IgG4, NSOI, and TED. Further studies with a large number of cases are needed to confirm this finding, especially with regard to uncommon diseases. Orbital CT showed moderate sensitivity and good specificity for identifying active TED. |
