首页> 外文期刊>AJNR. American journal of neuroradiology >Quantification of orbital apex crowding for screening of dysthyroid optic neuropathy using multidetector CT
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Quantification of orbital apex crowding for screening of dysthyroid optic neuropathy using multidetector CT

机译:使用多探测器CT定量检查眶尖拥挤以筛查甲状腺功能减退性视神经病变

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BACKGROUND AND PURPOSE: DON, a serious complication of GO, is frequently difficult to diagnose clinically in its early stages because of confounding signs and symptoms of congestive orbitopathy. We evaluated the ability of square area measurements of orbital apex crowding, calculated with MDCT, to detect DON. MATERIALS AND METHODS: Fifty-six patients with GO were studied prospectively with complete neuro-ophthalmologic examination and MDCT scanning. Square measurements were taken from coronal sections 12 mm, 18 mm, and 24 mm from the interzygomatic line. The ratio between the extraocular muscle area and the orbital bone area was used as a CI. Intracranial fat prolapse through the superior orbital fissure was recorded as present or absent. Severity of optic nerve crowding was also subjectively graded on coronal images. Orbits were divided into 2 groups (with or without clinical evidence of DON) and compared. RESULTS: Ninety-five orbits (36 with and 59 without DON) were studied. The CIs at all 3 levels and the subjective crowding score were significantly greater in orbits with DON (P < .001). No significant difference was observed regarding intracranial fat prolapse (P = .105). The area under the ROC curves was 0.91, 0.93, and 0.87 for CIs at 12, 18, and 24 mm, respectively. The best performance was at 18 mm, where a cutoff value of 57.5% corresponded to 91.7% sensitivity, 89.8% specificity, and an odds ratio of 97.2 for detecting DON. A significant correlation (P < .001) between the CIs and VF defects was observed. CONCLUSIONS: Orbital CIs based on area measurements were found to predict DON more reliably than subjective grading of orbital crowding or intracranial fat prolapse.
机译:背景与目的:DON是GO的一种严重并发症,由于充血性眼病的体征和症状混杂,在临床上通常很难对其早期进行诊断。我们评估了用MDCT计算的眶尖拥挤的平方面积测量值检测DON的能力。材料与方法:对56例GO患者进行了全面的神经眼科检查和MDCT扫描前瞻性研究。从距zy间线12 mm,18 mm和24 mm的冠状切片进行平方测量。眼外肌面积与眼眶骨面积之比用作CI。颅内脂肪通过眶上裂的脱垂被记录为存在或不存在。在冠状图像上也对主观视神经拥挤的严重程度进行了分级。将轨道分为两组(有或没有DON的临床证据)并进行比较。结果:研究了九十五个轨道(有DON的36个轨道和没有DON的59个轨道)。在DON的眼眶中,所有3个水平的CI和主观拥挤评分均显着更高(P <.001)。颅内脂肪脱垂没有观察到显着差异(P = .105)。对于CI在12、18和24毫米处,ROC曲线下的面积分别为0.91、0.93和0.87。最佳性能是在18 mm处,其中临界值57.5%对应于检测DON的灵敏度为91.7%,特异性为89.8%和比值为97.2。观察到CI与VF缺陷之间存在显着相关性(P <.001)。结论:发现基于面积测量的眶CI比预测主动脉分级的拥挤或颅内脂肪脱垂更可靠地预测DON。

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