中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2012, Vol. 34 ›› Issue (5): 461-467.doi: 10.3881/j.issn.1000-503X.2012.05.005

• 论著 • 上一篇    下一篇

高场磁共振在Graves眼病患者眼外肌定量测量中的应用价值

陈钰,金征宇,张竹花,徐冬冬,孟薇,姜波,房洪营,孙照勇,陈颖,孙宏毅,冯逢   

  1. 中国医学科学院 北京协和医学院 北京协和医院放射科,北京 100730
  • 收稿日期:2012-09-10 修回日期:2012-11-07 出版日期:2012-10-31 发布日期:2012-10-31
  • 通讯作者: 张竹花 电话:010-69155509,电子邮件:zhangzhuhua2003@hotmail.com E-mail:zhangzhuhua2003@hotmail.com

Quantitative Evaluation of Extraocular Muscle with High-field Magnetic Resonance in Patients with Graves’ Ophthalmopathy with Upper-lid Retraction

CHEN Yu, JIN Zheng-yu, ZHANG Zhu-hua, XU Dong-dong, MENG Wei,JIANG Bo,FANG Hong-ying, SUN Zhao-yong, CHEN Ying, SUN Hong-yi, FENG Feng   

  1. Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2012-09-10 Revised:2012-11-07 Online:2012-10-31 Published:2012-10-31

摘要:

目的 探讨高场磁共振测量眼外肌的厚度及宽度的可行性,计算厚度及宽度的比值,并且评价以上睑退缩为主要表现的Graves眼病(GO)患者眼外肌径线及其比值的特点。方法 所有受试对象均行高场眼眶磁共振增强检查。在轴位、冠状位及斜矢状位T1加权增强图像上分别测量各眼外肌的厚度及宽度,并且计算R1值(厚度与宽度比值)及R2值(宽度与厚度比值)。当径线或比值大于对照组平均值的2倍标准差时,认为该径线或比值增加。结果 GO组患者提上睑肌厚度、内直肌厚度、下直肌厚度及上斜肌宽度大于对照组,差异具有统计学意义(P=0.0007, P=0.017, P=0.032, P=0.000)。提上睑肌、下直肌、内直肌及外直肌R1值大于对照组,差异具有统计学意义(P=0.000, P=0.037, P=0.019, P=0.032)。上斜肌R2值大于对照组,差异具有统计学意义(P=0.027)。与对照组相比,GO组患者共32条眼外肌厚度增加,其中47%眼外肌R1值也增加。结论 眼眶高场磁共振增强扫描能用于眼外肌厚度与宽度的定量评价。以上睑退缩为主要临床症状的GO患者,除了提上睑肌增厚外,同时伴有其他眼外肌增厚。此外,GO患者上斜肌肥大以宽度增加为主。R1值与R2值能反映眼外肌厚度与宽度变化的程度及相互关系。

关键词: 磁共振, Graves眼病, 上睑退缩, 眼外肌

Abstract:

Objective To evaluate the feasibility of high-field magnetic resonance in measuring the thickness and width of extraocular muscles, calculate the ratio of thickness to width, and summarize the characters of the diameters and its ratio in patients with Gaves’ ophthalmopathy (GO) with upper-lid retraction. Methods Sixteen GO patients with upper-lid retraction (GO group) and 14 healthy control group were enrolled in this study. All the patients underwent enhanced high-field magnetic resonance orbital scan. The thickness and width of extrocular muscles were measured on axial, coronal or oblique sagittal enhanced T1 weighted images. The ratio of thickness to width (R1) and width to thickness (R2) were calculated. The diameters or ratio was evaluated as enlarged when they were 2 standard deviation greater than mean values of extraocular muscle in healthy control. Results The thickness of levator palpebrae superioris, medial rectus, and inferior rectus muscles in GO group were significantly larger than those in the control group (P=0.000, P=0.017, P=0.032, respectively. The width of superior oblique muscles in GO group was significantly larger than that in control group (P=0.000). The R1 values of levator palpebrae superioris, inferior rectus, medial rectus, and lateral rectus muscles in GO group were significant larger than those in the control group (P=0000,P=0.037, P=0019,P=0.032, respectively. The R2 value of superior oblique muscles was significant larger than that in the control group (P=0.027). Aslo in GO group, 32 extraocular muscles showed an increased thickness 47% of thickened extraocular muscles had an increased R1. Conclusions Enhanced orbit imaging with high-field magnetic resonance is helpful in the quantitative assessment of the thickness and width of extraocular muscles. In GO patients, in addition to the levator palpebrae superioris muscles, some other extraocular muscles also becomes thicker. Moreover, the increased diameters of superior oblique muscles is mainly due to the increase of its width R1 and R2 values can reflect the thickness and width of extraocular muscles and their relationship.

Key words: magnetic resonance, Graves&rsquo, ophthalmopathy, upper-lid retraction, extraocular muscle

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