Low signal intensities of MRI T1 mapping predict refractory diplopia in Graves’ ophthalmopathy

Autor: Shin-ichi Taniguchi, Masahiko Kato, Tsuyoshi Okura, Masamichi Kurosaki, Kazuhiro Yamamoto, Shinya Fujii, Kazuhisa Matsumoto, Dai Miyazaki, Shoichiro Izawa, Ayumi Kato, Kenji Fukaya, Kazuhiko Matsuzawa
Rok vydání: 2020
Předmět:
Zdroj: Clinical Endocrinology. 92:536-544
ISSN: 1365-2265
0300-0664
Popis: Objective In Graves' ophthalmopathy (GO), fibrosis in extraocular muscles (EOMs) may be related to intravenous glucocorticoid (ivGC)-resistant diplopia. Signal intensity (SI) of magnetic resonance imaging (MRI) T1 mapping can quantify properties of EOM components, including fibrosis. We investigated EOM features of GO patients with diplopia using T1 mapping SI and the predictive value of T1 mapping SI in the response of diplopia to ivGCs. Design We performed a cross-sectional study that included 13 active GO patients, 34 inactive GO patients with history of diplopia, including 20 with a history of diplopia disappearance, 14 GO patients with refractory diplopia and 35 control subjects. In nine active GO patients, the relationship between T1 mapping SI at pretreatment and at diplopia outcome after ivGC treatment was prospectively investigated. Methods T1 mapping SI of left and right inferior rectus and medial rectus muscles was measured in all participants. Results T1 mapping SI in inactive GO patients with refractory diplopia was significantly lower than that of other groups in all evaluated EOMs. Diagnostic accuracy for refractory diplopia by T1 mapping SI in GO patients with a history of diplopia disappearance was excellent (AUC 0.89) compared with other assessments. Furthermore, among nine active GO patients, pretreatment T1 mapping SI in four patients with ivGC-resistant diplopia tended to be low compared with the other five patients with improved diplopia. Conclusions Low intensity T1 mapping in EOMs is likely to be associated with refractory diplopia and may be useful in predicting the response of diplopia to ivGCs.
Databáze: OpenAIRE