Diagnostic accuracy of short-time inversion recovery sequence in Graves-ophthalmopathy before and after prednisone treatment

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• 作者：Fabio Tortora (1)
  Mariaevelina Prudente (2) (3)
  Mario Cirillo (4)
  Andrea Elefante (5)
  Maria Paola Belfiore (1)
  Francesco Romano (1)
  Salvatore Cappabianca (1)
  Carlo Carella (6)
  Sossio Cirillo (1)
  
• 关键词：Graves-Ophthalmopathy ; Oedematous phase ; SIR in STIR
• 刊名：Neuroradiology
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：56
• 期：5
• 页码：353-361
• 全文大小：
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• 作者单位：Fabio Tortora (1)
  Mariaevelina Prudente (2) (3)
  Mario Cirillo (4)
  Andrea Elefante (5)
  Maria Paola Belfiore (1)
  Francesco Romano (1)
  Salvatore Cappabianca (1)
  Carlo Carella (6)
  Sossio Cirillo (1)
  
  1. Department of Clinical and Experimental Medicine and Surgery, “F. Magrassi–A. Lanzara-Second University of Naples, c/o C.T.O, Colli Aminei Street, 21, 80131, Naples, Italy
  2. Medicine Department, Second University of Naples, Naples, Italy
  3. Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
  4. Neuroradiological Service, Second University of Naples, Naples, Italy
  5. Neuroradiological Department, Federico II University, Naples, Italy
  6. Polidiagnostic Center Check-Up, Salerno, Italy
  
• ISSN：1432-1920

文摘

Introduction In Graves-Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS-lt;-) from active Graves-Ophthalmopathy (GO) (CAS-gt;-) subjects and, second, to follow post-steroid treatment disease. Methods An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations. Results In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness. Conclusion In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement.