【作者】 洪庆山； 薛耀明； 沈洁；

【Author】 HONG Qing-shan;SHEN Jie;XUE Yao-ming;LIN Zhi-chun;CHEN Yan-ping;Nanfang Hospital,Southern Medical University;

【机构】 南方医科大学南方医院内分泌代谢科；

【摘要】 目的:根据NOSPECS评分探讨不同临床分级TAO的MRI影像变化。方法:收集2006.1~2008.1南方医院内分泌代谢科治疗的64例TAO患者资料,男29例,女35例,年龄18~68岁。正常对照组选择门诊健康检查者。严重度分级根据Werner NOSPECS分级标准。使用德国SIEMENS Magnetism Vision Plus 1.5T磁共振扫描仪,采用头部线圈。结果:NOSPECS 2级MRI表现为眼睑、泪腺和提上睑肌等软组织体积增厚。NOSPECS 3级眼眶内球后组织增厚,8例患者出现眼外肌增厚。NOSPECS 4级眼外肌受累、肥厚。NOSPECS 5级MRI对角膜的显示欠满意。NOSPECS 6级表现为视神经轴受压、行程改变,蛛网膜下腔局部中断。结论:MRI能显示TAO不同严重度分级的病理改变,增加了早期不典型4级TAO的发现率,克服了NOSPECS评分滞后的缺陷。更多还原

【Abstract】 Objective:To describe MRI manifestations of thyroid associated ophthalmopathy(TAO) in every clinical grade defined by NOSPECS Scores.Methods 64 TAO cases were collected in Endocrinology& Metabolism Dept.Nanfang Hospital,29 males and 35 females,Aging 18~68yrs.Severity of TAO was evaluated by Werner NOSPECS Scores.All the cases were examined by MRI scan,Siemens Magnetism Vision Plus 1.5T.Scanning plan included spin echo sequence,STIR(Short TI Inversion recovery) sequence,SE dual-echo sequence and SE dual-echo sequence with dispose suppression.Results:NOSPECS Scores graded 64 TAOs into:1 in Grade 2.13 in Grade 3,EOM was enlarged in 8 cases.5 of them displayed a high intensity signal in STIR T2 WI.45 cases were in Grade 4 in total,15 mild,28 moderate,2 severe.EOMs were found enlarged in both sides.3 cases were in Grade 5.It was difficult for MRI to show cornea.2 cases were in Grade 6.Optic neural axis,enveloping the nerve,was suppressed and translocated in MRI pictures.Conclusion:MRI demonstrates the pathological changes in different grading TAO and detects more early,untypical grade 4 cases,therefore overcomes the shortcoming of NOSPECS Scores.更多还原