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Fractional anisotropy and diffusivity changes in thyroid-associated orbitopathy

  • Head and Neck Radiology
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Abstract

Introduction

To investigate the extraocular muscle (EOM) changes in thyroid-associated orbitopathy (TAO) on DTI and the correlations between DTI parameters and clinical features.

Methods

Twenty TAO patients and 20 age- and sex-matched controls provided informed consent and were enrolled. Ten-directional DTI was acquired in orbit. Fractional anisotropy (FA), mean, axial, and radial diffusivities were obtained at medial and lateral EOMs in both orbits. EOM thickness was measured in patients using axial CT images. FA and diffusivities were compared between patients and controls. The relationships between DTI values and muscle thickness and exophthalmos were evaluated. DTI values compared between patients in active and inactive phases by clinical activity score of TAO. DTI values were also compared between acute and chronic stages by the duration of disease.

Results

In medial EOM, FA was significantly lower in patients (p < 0.001) and negatively correlated with muscle thickness (r = −0.604, p < 0.001). Radial diffusivity was significantly higher in patients (p = 0.010) and correlated with muscle thickness (r = 0.349, p = 0.027). In lateral EOM, DTI values did not differ between patients and controls. In the acute stage, the diffusivities of the medial rectus EOM were increased compared with the chronic stage. DTI values of the medial and lateral rectus EOM did not differ significantly between active and inactive phases.

Conclusion

DTI can be used to diagnose TAO with FA and radial diffusivity change in EOM. Diffusivities can be used to differentiate acute and chronic stage of TAO. However, DTI values showed limitation in reflecting TAO activity according to the CAS.

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Acknowledgments

This study was supported by the Korea University College of Medicine (K1325441) and the Department of Radiology, Korea University College of Medicine (KUMCRG 06142).

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Authors and Affiliations

  1. Department of Radiology, Korea University Ansan Hospital, Jeokgum-ro 123, Gojan-dong, Ansan, Gyeonggido, 15355, South Korea

    Ji Sung Han, Hyung Suk Seo & Young Hen Lee

  2. Department of Ophthalmology, Korea University Ansan Hospital, Ansan, South Korea

    Hwa Lee

  3. Department of Radiology, Korea University Guro Hospital, Seoul, South Korea

    Sang-il Suh

  4. Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, USA

    Eun-Kee Jeong & Nabraj Sapkota

  5. Department of Neurosurgery, Nanoori Hospital, Seoul, South Korea

    Ki Joon Kim

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  1. Ji Sung Han
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Correspondence to Hyung Suk Seo.

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We declare that all human studies have been approved by the Korea University Ansan Hospital Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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Han, J.S., Seo, H.S., Lee, Y.H. et al. Fractional anisotropy and diffusivity changes in thyroid-associated orbitopathy. Neuroradiology 58, 1189–1196 (2016). https://doi.org/10.1007/s00234-016-1764-0

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  • DOI: https://doi.org/10.1007/s00234-016-1764-0

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