The diagnostic value of the IDEAL-T2WI sequence in dysthyroid optic neuropathy: a quantitative analysis of the optic nerve and cerebrospinal fluid in the optic nerve sheath

Wu, Hongyu; Luo, Ban; Yuan, Gang; Wang, Qiuxia; Liu, Ping; Zhao, Yali; Zhai, Linhan; Ma, Yanqiang; Lv, Wenzhi; Zhang, Jing

doi:10.1007/s00330-021-08030-5

Cited by 17 publications

(14 citation statements)

References 40 publications

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“…All this evidence suggests that TAO is an eye-brain neuropathy that is not limited to damage to the eye. A variety of radiologic metrics has been utilized to assist in the diagnosis of optic nerve alterations, such as detection of apical crowding on scanning, decreased diameter of the optic nerve on T1-weighted imaging, ADC value to measure the optic nerve, and T2 mapping to detect intraorbital optic nerve changes ( 25 , 26 ), study on the posterior visual pathway still remains few.…”

Section: Discussionmentioning

confidence: 99%

Thyroid-associated ophthalmopathy: Using diffusion tensor imaging to evaluate visual pathway microstructural changes

Li²,

Wang³

2022

Front. Neurol.

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ObjectiveThe aim of this study was to determine whether the visual pathway is affected by thyroid-associated ophthalmopathy (TAO) before the development of dysthyroid optic neuropathy (DON) with diffusion tensor imaging (DTI).Materials and methodsFifty-seven TAO patients (22 mild, 35 moderate-severe TAO) and 30 healthy controls (HCs) were included. The DTI parameters of the lateral geniculate (LG) and optic radiation (OR) were measured. A full ophthalmic examination such as intraocular pressure, exophthalmos, and visual acuity was performed. Clinical activity scores (CAS) were also calculated. One-way ANOVA and Pearson's correlation were carried out. A binary logistic regression was used to identify variables that can diagnose TAO.ResultsModerate-severe TAO patients showed significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) than HCs for both LG and OR (p < 0.05). FA of OR was negatively correlated with CAS and intraocular pressure (p < 0.05). Multivariate analysis showed that FA of LG and FA of OR were a significant predictor for the diagnosis TAO.ConclusionDiffusion tensor imaging parameters of the visual pathway were significantly altered in moderate-severe TAO patients. The FA of LG, in particular, can be used as a sensitive imaging biomarker for assessing subclinical visual pathway damage in TAO.

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Section: Discussionmentioning

confidence: 99%

Thyroid-associated ophthalmopathy: Using diffusion tensor imaging to evaluate visual pathway microstructural changes

Li²,

Wang³

2022

Front. Neurol.

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“…TAO was diagnosed, based on the guidelines issued by Bartley and Gorman 20 . The diagnosis of DON was made based on two or more of the following clinical findings: relative contribution of afferent pupillary defect, color visual defect, decreased visual acuity, papilledema, visual field defect, abnormal pattern visual evoked potential test, and radiological evidence of apical crowding sign 21 …”

Section: Methodsmentioning

confidence: 99%

Functional and Morphological Brain Alterations in Dysthyroid Optic Neuropathy: A Combined Resting‐State fMRI and Voxel‐Based Morphometry Study

Luo

Wang

et al. 2022

Magnetic Resonance Imaging

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Background: Increasing evidence has indicated that the entire visual pathway from retina to visual cortex may be involved in dysthyroid optic neuropathy (DON) pathological mechanisms. Purpose: To explore the functional and morphological brain characteristics in DON and their relationship with ophthalmologic performance. Study Type: Retrospective. Population: A total of 30 DON patients, 40 thyroid-associated ophthalmopathy (TAO) without DON patients and 21 healthy-controls (HCs). Field Strength/Sequence: A 3.0 T, 3D T1-weighted spoiled gradient-recalled echo and gradient-recalled echo-planar imaging. Assessment: Functional and structural alterations in brain regions were evaluated with fractional amplitude of lowfrequency fluctuations, degree centrality (DC), and gray matter volume (GMV). Clinical activity score (CAS) is assessed across patients. Statistical Test: One-way analysis of variance with post hoc two sample t-tests (GRF-corrected, voxel level: P < 0.005, cluster level: P < 0.05) and correlation analysis (significance level: P < 0.05). Results: Compared to HCs, DON patients had significantly decreased DC values in the bilateral BA17 and BA18 regions. Compared to the TAO group, DON patients had decreased GMV in the left anterior cingulate cortex, left middle frontal gyrus, left lingual gyrus, left parietal gyrus, right Rolandic operculum, left supplementary motor area, and right middle temporal gyrus. In addition, GMV in the right Rolandic operculum was significantly positively correlated with CAS (correlation coefficient: r = 0.448). Data Conclusion: This study showed significant morphological and functional alterations in visual cortex and morphological alterations in partial default mode network regions of DON patients, which may provide insights into the mechanism of vision loss and may facilitate the diagnosis and treatment of DON. Evidence Level: 3. Technical Efficacy: Stage 3.

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“…All MRI scans were conducted on a 3.0 T MR machine (Discovery 750; GE Healthcare) using a 32-channel head coil. The patients were placed in the head-first supine position with their eyes closed during the MRI scanning [ 11 ]. Coronal IDEAL-T2WI and axial IDEAL-T2WI sequences were obtained, providing water images.…”

Section: Methodsmentioning

confidence: 99%

“…They ignored the impairment of the optic nerve itself [4,[7][8][9][10]. However, several studies have revealed the diameter and the water fraction of the optic nerve are positively correlated with disease activity [11], which further indicates the potential value of the optic nerve in detecting DON patients.…”

Section: Introductionmentioning

confidence: 99%

Radiomics analysis of the optic nerve for detecting dysthyroid optic neuropathy, based on water-fat imaging

Luo

Zhao

et al. 2022

Insights Imaging

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Objective Detecting dysthyroid optic neuropathy (DON) in the early stages is vital for clinical decision-making. The aim of this study was to determine the feasibility of using an optic-nerve-based radiomics nomogram on water-fat imaging for detecting DON. Methods This study included 104 orbits (83 in the training cohort) from 59 DON patients and 131 orbits (80 in the training cohort) from 69 thyroid-associated ophthalmopathy (TAO) without DON patients. Radiomic features were extracted from the optic-nerve T2-weighted water-fat images for each patient. Selected radiomics features were retrained to construct the radiomic signature model and calculate the radiomic score (Rad-score). The conventional MRI evaluation model was constructed based on apical crowding sign, optic-nerve stretching sign and muscle index. The radiomics nomogram model combining the Rad-score and conventional MRI evaluation factors was then developed. Predictive performance of the three models was assessed using ROC curves. Results Eight radiomics features from water-fat imaging were selected to build the radiomics signature. The radiomics nomogram (based on Rad-score, apical crowding sign and optic-nerve stretching sign) had superior diagnostic performance than did the conventional MRI evaluation model (AUC in the training set: 0.92 vs 0.80, the validation set:0.88 vs 0.75). Decision curve analysis confirmed the clinical usefulness of the radiomics nomogram. Conclusions This optic-nerve-based radiomics nomogram showed better diagnostic performance than conventional MRI evaluation for differentiating DON from TAO without DON. The changes of the optic-nerve itself may deserve more consideration in the clinical decision-making process.

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The diagnostic value of the IDEAL-T2WI sequence in dysthyroid optic neuropathy: a quantitative analysis of the optic nerve and cerebrospinal fluid in the optic nerve sheath

Cited by 17 publications

References 40 publications

Thyroid-associated ophthalmopathy: Using diffusion tensor imaging to evaluate visual pathway microstructural changes

Thyroid-associated ophthalmopathy: Using diffusion tensor imaging to evaluate visual pathway microstructural changes

Functional and Morphological Brain Alterations in Dysthyroid Optic Neuropathy: A Combined Resting‐State fMRI and Voxel‐Based Morphometry Study

Radiomics analysis of the optic nerve for detecting dysthyroid optic neuropathy, based on water-fat imaging

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