RÉSUMÉ
Objective To investigate the value of magnetic resonance imaging(MRI)T2-mapping in evaluating the activity of Graves ophthalmopathy(GO).Methods A total of 64 patients with GO in the Department of Endocrinology,the First Affiliated Hospital of Chongqing Medical University from July 2019 to January 2021 were collected.Simple random grouping was performed by computer,with 49 cases as observation subjects,and 15 patients for diagnostic test.According to clinical activity score(CAS),49 GO patients were divided into active group(CAS≥3 points,48 eyes)and inactive group(CAS<3 points,50 eyes).Normal control group(NC group)included 31 patients(62 eyes).All subjects underwent 3.0T orbital MRI T2-mapping.Measuring the T2 relaxation time(T2RT)of superior rectus,inferior rectus,medial rectus,and lateral rectus on five layers behind the eyeball on T2-mapping coronal images,and select the maximum value of T2RT in the five layers for each extraocular muscle to represent the T2RT of this extraocular muscle.Finally,select the maximum T2RT values of the four extraocular muscles,expressed as extraocular muscle maximum T2RT.Compare the differences of the above 5 indicators(superior rectus T2RT,inferior rectus T2RT,medial rectus T2RT,lateral rectus T2RT,extraocular muscle maximum T2RT)between active group,inactive group and NC group.ROC curve was used to analyze the diagnostic value of the above 5 indicators for GO activity assessment,and the diagnostic threshold was obtained.Then,another 15 GO patients were performed for diagnostic tests evaluation to determine the indicators of high diagnostic efficacy and the threshold of diagnostic activity.Results The T2RT of all extraocular muscles in active group were significantly higher than those in inactive group and NC group,the difference was statistically significant(P<0.001).The threshold value of the five indicators were obtained by ROC curve analysis.The maximum T2RT cut-off values of superior rectus muscle,inferior rectus muscle,medial rectus muscle,lateral rectus muscle and extraocular muscles for judging activity were 80.200 ms,97.045 ms,94.355 ms,85.750 ms and 101.385 ms respectively.Another 15 GO patients were performed for diagnostic tests,the indexes with relatively high sensitivity,specificity,positive predictive value and negative predictive value were inferior rectus T2RT and extraocular muscle maximum T2RT,the cut-off values of GO activity were 97.045 ms and 101.385 ms,respectively;the sensitivity were 91.7％and 93.8％,respectively;the specificity all were 80.0％.Conclusions MRI T2-mapping sequence has a good value in assessment of GO activity.The inferior rectus T2RT and extraocular muscle maximum T2RT can be choosed to evaluate the activity of GO.
RÉSUMÉ
<p><b>OBJECTIVE</b>To in vivo dynamically observe the time-effect characteristic of local stimulating effect on acupoints after micro-invasion embedding, which could provide references for the interval period of micro-invasion embedding.</p><p><b>METHODS</b>With magnetic resonance imaging (MRI) technique, the local T2WI fat-suppression images and T2 Mapping 8-echo sequence images were collected at multiple time points from 8 healthy subjects who received embedding at left Sanyinjiao (SP 6).After the 8-echo sequence images were transformed into T2 Mapping images by using software FuncTool, the T2 average value of embedding area was measured, and the changes of local signal strength of T2WI fat-suppression images and T2 average value along with time after embedding at left Sanyinjiao (SP 6)were analyzed.</p><p><b>RESULTS</b>Compared before embedding, the signal strength of local T2WI fat-suppression images and the T2 average value began to increase 8 h after being embedded(<0.01); the signal strength of T2WI fat-suppression images and the T2 average value were significantly increased 3 d and 7 d after being embedded(all<0.01);the signal strength of local T2WI fat-suppression images and the T2 average value 14 d after being embedded were lower than those at previous 2 time points, but higher than those before embedding(both<0.01); 21 d, 28 d and 35 d after embedding, the signal strength of local T2WI fat-suppression images and the T2 average value were similar to those before treatment (all>0.05).</p><p><b>CONCLUSIONS</b>After micro-invasion embedding at Sanyinjiao (SP 6), the stimulation effect period on acupoint is approximately 21 days.When applying micro-invasion embedding under similar condition at acupoints which has similar structure as Sanyinjiao (SP 6), the interval period of embedding could consider 21 days as a reference.</p>