Document Detail


Correlation of signal intensity ratio on orbital MRI-TIRM and clinical activity score as a possible predictor of therapy response in Graves' orbitopathy--a pilot study at 1.5 T.
MedLine Citation:
PMID:  19756565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: This study seeks to describe the predictive value of the signal intensity ratio (SIR) in magnetic resonance imaging-turbo inversion recovery magnitude (MRI-TIRM) in patients with Graves' orbitopathy (GO) with regard to predictability of therapy response. METHODS: Included in this prospective pilot study were 36 consecutive patients with GO and 25 control subjects. Patients were clinically assessed according to the European Group on Graves' Orbitopathy recommendations with active GO defined by a clinical activity score (CAS) > or = 3. On magnetic resonance (MR) imaging, muscle inflammation was measured with a region of interest set within the brightest extra-ocular muscle both on coronal turbo inversion recovery magnitude (TIRM) and on fat suppressed gadolinium-enhanced T1-weighted sequences. To calculate the SIR, the measured signal intensity was set in proportion to that of the ipsilateral temporalis muscle. RESULTS: Signal intensity ratio in coronal T2-weighted TIRM sequences in either group ranged from 1.22 to 4.92 (mean 2.04) in patients with GO and from 1.18 to 2.4 (mean 1.63) in controls without GO. The observed differences were significant on the TIRM sequences (right eye p = 0.023; left eye p = 0.022), whereas, no significant differences could be detected on the T1-weighted sequences (right eye p = 0.396; left eye p = 0.498). A cut off value of SIR > 2.5 for a CAS > or = 4 to discriminate active from inactive patients was statistically calculated. CONCLUSION: T2 relaxation time is a reliable tool in detecting active GO. The difference in T2-SIR versus T1-SIR is helpful to distinguish inflammatory oedema of the extra ocular muscles from intra-orbital congestion due to reduced venous outflow.
Authors:
Eberhard C Kirsch; Achim H Kaim; Marion Gregorio De Oliveira; Georg von Arx
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Publication Detail:
Type:  Journal Article     Date:  2009-09-15
Journal Detail:
Title:  Neuroradiology     Volume:  52     ISSN:  1432-1920     ISO Abbreviation:  Neuroradiology     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-25     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  91-7     Citation Subset:  IM    
Affiliation:
Neuroradiology and Cranio-Facial-Center Hirslanden, Hirslanden Clinic Aarau, Schaenisweg, 5000 Aarau, Switzerland. eberhard.kirsch@hirslanden.ch
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Contrast Media / diagnostic use
Female
Functional Laterality
Gadolinium / diagnostic use
Graves Ophthalmopathy / diagnosis*,  pathology*,  therapy
Humans
Magnetic Resonance Imaging / instrumentation,  methods*
Male
Middle Aged
Oculomotor Muscles / pathology*
Pilot Projects
Prognosis
Prospective Studies
Severity of Illness Index*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Contrast Media; 7440-54-2/Gadolinium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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