99Tcm-DTPA SPECT/CT眼眶显像评价甲状腺相关性眼病活动性：与临床活动性评分及MRI的对比分析

The activity of thyroid-associated ophthalmopathy assessed by 99Tcm-DTPA orbit SPECT/CT: comparison with clinical activity score and MRI

    摘要
  • 摘要:
    目的 探讨99Tcm-二亚乙基三胺五乙酸（DTPA）SPECT/CT眼眶显像对甲状腺相关性眼病（TAO）活动性判断的价值。
    方法 回顾性分析2016年2月至2017年1月临床诊断为TAO的33例患者男性13例、女性20例，年龄（45.36±13.44）岁的66个眼眶的99Tcm-DTPA SPECT/CT图像、临床活动性评分（CAS）及其中21例患者（42个眼眶）的MRI图像。用感兴趣区（ROI）技术进行半定量分析，计算眼眶与枕部区域的摄取比值（UR）；用肉眼观察法分别判定SPECT/CT及MRI图像的每条眼外肌的活动性，并根据MRI处于活动期眼外肌的数量给每个眼眶进行CAS评分，≥3分判定为活动期，<3分为非活动期。活动期与非活动期TAO之间的UR比较采用t检验；UR与CAS评分、MRI评分之间的相关性采用Spearman相关性分析；SPECT/CT与MRI判断眼外肌活动性的一致性比较采用Kappa分析。绘制受试者工作特征（ROC）曲线，评价SPECT/CT诊断效能。
    结果 ① 66个眼眶的CAS评分与UR呈中度相关（r=0.441，P=0.000）；非活动期TAO的UR（1.20±0.58）低于活动期的UR（1.56±0.57），且差异有统计学意义（t=−2.476，P=0.016）。ROC曲线下面积为0.679，区分活动期与非活动期的UR阈值为1.20，灵敏度为79.5%，特异度为55.6%。② 42个眼眶的MRI评分与UR呈显著相关（r=0.515，P=0.000），非活动期TAO的UR（1.00±0.60）低于活动期的UR（1.72±0.45），且差异有统计学意义（t=−4.438，P=0.000）。③ 99Tcm-DTPA SPECT/CT与MRI对42个眼眶共168条眼外肌的活动性判断呈中度一致性（kappa=0.569，P=0.000）。
    结论 99Tcm-DTPA SPECT/CT眼眶显像是判断TAO活动性较为可靠及客观的影像学方法，值得在临床推广应用。

     

    Abstract:
    Objective To determine the value of 99Tcm-DTPA orbit SPECT/CT in evaluating the activity of thyroid-associated ophthalmopathy (TAO).
    Methods The 99Tcm-DTPA orbit SPECT/CT imaging data of 66 orbits of 33 patients 13 men and 20 women, age (45.36±13.44) years old were retrospectively analyzed, along with the clinical activity score (CAS) and MRI of the 21 patients (42 orbits) . The orbit/occipital area's uptake ratio (UR) was calculated by the ROI. The activity of each extraocular muscle (EOM) on the SPECT/ CT and MRI images was assessed by visual analysis. MRI score of every orbit was obtained according to the number of active EOM, the range of which was 0−4 . As for the CAS, ≥3 represented the active stage, and the others denote the inactive stage. The UR between the active TAO and inactive TAO was compared using t test, the correlation between the UR and CAS/MRI score was calculated by Spearman analysis, and the consistency of the activity of every EOM assessed by SPECT/CT and MRI was evaluated by Kappa test. The receiver operating characteristic (ROC) curve was depicted to determine the diagnostic efficiency of SPECT/CT using CAS as the gold standard.
    Results ① CAS was moderately correlated with the UR of all the 66 orbits (r=0.441, P=0.000). The UR of the inactive group (1.20±0.58) was significantly lower than that of the active group (1.56±0.57) (t=−2.476, P=0.016). The area under the curve of the ROC was 0.679. The threshold differentiating the inactive phase from the active one was 1.20, with the sensitivity of 79.5% and with the specificity being 55.6%. ② The MRI score of the 42 orbits was significantly correlated with UR (r=0.515, P=0.000). The UR of the inactive group (1.00±0.60) was significantly lower than that of the active group (1.72±0.45) according to the MRI score (t=−4.438, P=0.000). ③The activity of the 168 muscles assessed by 99Tcm-DTPA SPECT/CT was moderately consistent with that assessed by MRI (kappa=0.569, P=0.000).
    Conclusions 99Tcm-DTPA orbit SPECT/CT is a reliable and objective method to evaluate the activity of TAO, and it will be helpful in clinical practice.

     

    • HTML全文
    • 参考文献(14)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回