| 周奕含,罗莎,王爽,张娟,罗诗雨,李萌,鲜军舫,李眉.眼眶SEPCT/CT所获最大标准摄取值用于评估甲状腺相关眼病活动度及预测疗效[J].中国医学影像技术,2025,41(1):55~59 |
| 眼眶SEPCT/CT所获最大标准摄取值用于评估甲状腺相关眼病活动度及预测疗效 |
| Maximum standard uptake value obtained with orbital SEPCT/CT for evaluating activity of thyroid-associated ophthalmopathy and predicting curative efficacy |
| 投稿时间：2024-07-30 修订日期：2024-11-06 |
| DOI：10.13929/j.issn.1003-3289.2025.01.012 |
| 中文关键词: 格雷夫斯眼病 体层摄影术,发射型计算机,单光子 治疗转归 |
| 英文关键词:Graves ophthalmopathy tomography, emission-computed, single-photon treatment outcome |
| 基金项目:国家卫生健康委能力建设和继续教育中心放射影像数据库建设项目(YXFSC2022JJSJ009)。 |
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| 中文摘要: |
| 目的 观察眼眶SEPCT/CT所获最大标准摄取值(SUVmax)用于评估甲状腺相关眼病(TAO)活动度及预测疗效的价值。方法 回顾性收集96例临床首诊TAO患者,其中71例临床活动度评分(CAS)≥3分(活动期组)、25例CAS=2分(非活动期组)。行眼眶SEPCT/CT检查及激素或免疫抑制剂治疗3个月,于治疗结束后1周内再行CAS并复查眼眶显像,根据疗效分为有效组与无效组。比较活动期组与非活动期组眼外肌治疗前(pre)SUVmax(pre-SUVmax)及显像剂摄取率(UR)(pre-UR),有效组与无效组间pre-CAS、治疗后(post)CAS(post-CAS)及眼外肌pre-SUVmax、post-SUVmax、pre-UR、post-UR,以及治疗前后CAS、SUVmax及UR差值(△CAS、△UR、△SUVmax);分析SUVmax、UR与CAS的相关性。将pre-CAS、pre-SUVmax及pre-UR纳入单因素及多因素logistic回归分析,筛选TAO治疗有效的预测因素。结果 活动组眼外肌pre-SUVmax、pre-UR均高于非活动组(P均＜0.05)。治疗后有效组70例、无效组26例;有效组pre-CAS、pre-CAS≥3分者占比、pre-SUVmax、pre-UR、△CAS、△SUVmax及△UR均高于无效组(P均＜0.05)。TAO患者眼外肌pre-SUVmax及pre-UR均与pre-CAS呈正相关(rs=0.419、0.395,P均＜0.001),post-SUVmax、post-UR均与post-CAS呈正相关(rs=0.322、0.221,P=0.001、0.030),△SUVmax、△UR均与△CAS呈正相关(rs=0.368、0.206,P＜0.001、P=0.044)。pre-CAS≥3分(OR=2.95)和pre-SUVmax(OR=4.22)均为TAO治疗有效的独立预测因素(P均＜0.05)。结论 以眼眶SEPCT/CT所获SUVmax能定量评估TAO活动度及预测疗效。 |
| 英文摘要: |
| Objective To investigate the value of the maximum standard uptake value (SUVmax) obtained with orbital SEPCT/CT for evaluating activity of thyroid-associated ophthalmopathy (TAO) and predicting curative efficacy. Methods A total of 96 patients with initially diagnosed TAO were retrospectively collected, including 71 with clinical activity score (CAS)≥3 (active group) and 25 with CAS=2 (inactive group). Data of orbital SEPCT/CT were collected, and the patients were treated with hormones or immunosuppressants for 3 months. CAS was performed again within 1 week after treatment, and orbital imaging was reviewed. The patients were divided into effective group and ineffective group according to treatment results. Pretreatment (pre) SUVmax (pre-SUVmax) and imaging agent uptake rate (UR) (pre-UR) in extraocular muscle were compared between active and inactive groups. Pre-CAS, post-treatment (post) CAS (post-CAS), as well as pre-SUVmax, post-SUVmax, pre-UR, post-UR and the difference of pre- and post-treatment CAS, SUVmax and UR (△CAS, △UR, △SUVmax) of extraocular muscle were compared between effective group and ineffective group. The correlations of SUVmax, UR and CAS were analyzed. Pre-CAS, pre-SUVmax and pre-UR were included in univariate and multivariate logistic regression analysis to screen the predictors of effective treatment of TAO. Results Pre-SUVmax and pre-UR of extraocular muscle in active group were higher than those in inactive group (both P＜0.05). Among 96 cases, 70 were in effective group and 26 were in ineffective group. Pre-CAS, the proportion of pre-CAS≥3 scores, pre-SUVmax, pre-UR, △CAS, △SUVmax and △UR in effective group were all higher than those in ineffective group (all P＜0.05). Pre-SUVmax and pre-UR in extraocular muscle of TAO patients were positively correlated with pre-CAS (rs=0.419, 0.395, both P＜0.001), while post-SUVmax and post-UR were positively correlated with post-CAS (rs=0.322, 0.221, P=0.001, 0.030), △SUVmax and △UR were positively correlated with △CAS (rs=0.368, 0.206, P＜0.001, P=0.044). Pre-CAS≥3 (OR=2.95) and pre-SUVmax (OR=4.22) were both independent predictors of effective treatment of TAO (both P<0.05). Conclusion SUVmax obtained with orbital SEPCT/CT could be used to quantitatively assess TAO activity and predict curative efficacy. |
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