Usefulness of readout-segmented EPI-based diffusion tensor imaging of lacrimal gland for detection and disease staging in thyroid-associated ophthalmopathy

Lu Chen,Wen Chen,Qian Wu,Huan-Huan Chen,Jiang Zhou,Hao Hu,Hai-Bin Shi,Fei-Yun Wu,Xiao-Quan Xu

doi:10.1186/s12886-021-02044-9

Lu Chen, Wen Chen + Show 7 more

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https://doi.org/10.1186/s12886-021-02044-9

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Abstract

BackgroundDysfunction of lacrimal gland (LG) gains increasing attention in patients with thyroid-associated ophthalmopathy (TAO), while the underlying pathological change is still not fully established. This study aimed to evaluate the utility of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in non-invasively detecting microstructural alterations of LG in patients with TAO, as well as in discriminating disease activity.MethodsThirty TAO patients and 15 age- and sex- matched healthy controls, who underwent rs-EPI-based DTI, were retrospectively enrolled. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of LG, and clinical-endocrinological variables were collected and compared. The correlations between FA and ADC values of LG and serum thyroid biochemical markers were also assessed.ResultsTAO group showed significantly lower FA (P < 0.001) and higher ADC (P = 0.014) of LG than healthy group. Active subgroup had significantly lower FA (P < 0.001) and higher ADC (P < 0.001) than inactive subgroup. In TAO group, FA of LG was significantly and negatively correlated with TRAb (r=-0.475, P = 0.008), while ADC of LG showed no significant correlation (P > 0.05). The area under receiver operating characteristic curve of FA was significantly greater than that under curve of ADC for discriminating disease activity (0.832 vs. 0.570, P = 0.009).Conclusionsrs-EPI-based DTI is a useful tool to characterize the microstructural change of LG in patients with TAO. The derived metrics, particularly FA, can help to reveal disease activity.

Highlights

Dysfunction of lacrimal gland (LG) gains increasing attention in patients with thyroid-associated ophthalmopathy (TAO), while the underlying pathological change is still not fully established
Besides the traditionally documented pathogeneses regarding anatomical changes of widened vertical palpebral fissure and increased exophthalmos that accelerate the evaporation of tears, decreased secretion of tears due to lacrimal gland (LG) involvement has been considered as another crucial factor [3,4,5,6]
The exclusion criteria were as follows: (1) readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) was not acquired during pretreatment orbital magnetic resonance imaging (MRI); (2) image quality was inadequate for further analysis; (3) history of radiotherapy, surgical rehabilitation or decompression; (4) other ophthalmopathies such as glaucoma, diabetic retinopathy, and uveitis; (5) other immunological disorders such as IgG4-related disease and idiopathic inflammatory pseudotumor

Summary

Introduction

Dysfunction of lacrimal gland (LG) gains increasing attention in patients with thyroid-associated ophthalmopathy (TAO), while the underlying pathological change is still not fully established. This study aimed to evaluate the utility of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in noninvasively detecting microstructural alterations of LG in patients with TAO, as well as in discriminating disease activity. Along with the development of imaging techniques, a few studies have investigated the dysfunction of LG in TAO cohort through non-invasive approaches [6, 8,9,10]. The change of LG was still assessed in morphological and semi-quantitative approaches, underlying pathological information of LG remains not fully studied

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