BACKGROUND Lacrimal gland (LG) involvement in patients with Graves ophthalmopathy (GO) has been considered as a potential cause of the associated GO symptoms and different studies demonstrated the LG involvement in patients with GO than healthy controls. The aim of this study was to evaluate LG involvement, through measurement of its herniation, using a magnetic resonance imaging (MRI) index, in patients with different GO activities. METHODS Thirty-two consecutive Caucasian patients affected by GO were enrolled and grouped in group A (16 with inactive GO, CAS < 3) and B (16 with active GO, CAS ≥ 3) according to their GO activity. All patients underwent clinical-endocrinological assessment, a complete ocular evaluation, and orbital MRI examination. RESULTS No difference was found between the hormonal parameters, thyroid ultrasound-derived parameters, and thyroid-stimulating hormone (TSH) receptor (TSH-R) antibodies (TRAb) levels in group B and those in group A. The LG herniation (LGH) measurement evaluated by MRI was significantly higher in group B for both right (10.1 (7.3-17) vs. 7 (0-3.4) mm; p = 0.004) and left (8.5 (6.6-13) vs. 5.8 (0-12) mm; p = 0.026) eye than group A. A positive correlation was found between TRAb and LGH herniation (Rho 0.462, p = 0.009). CONCLUSIONS Measurement of LGH seems to be a good marker of the disease and GO activity. KEY POINTS • Lacrimal gland herniation is a simple index related to disease activity • Lacrimal gland herniation is correlated to TRAb levels • Lacrimal gland evaluation could be useful to differentiate active from inactive Graves ophthalmopathy in an early stage of disease.

中文翻译：

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Graves 眼病中的泪腺疝：一种简单而有用的疾病活动性 MRI 生物标志物。

背景 Graves 眼病 (GO) 患者的泪腺 (LG) 受累被认为是相关 GO 症状的潜在原因，不同的研究表明 GO 患者的 LG 受累高于健康对照。本研究的目的是通过使用磁共振成像 (MRI) 指数测量 LG 的突出情况，评估具有不同 GO 活动的患者的 LG 受累情况。方法 连续入选 32 名受 GO 影响的白种人患者，并根据他们的 GO 活动性将其分为 A 组（16 例非活动性 GO，CAS < 3）和 B 组（16 例活动性 GO，CAS ≥ 3）。所有患者均接受了临床内分泌学评估、完整的眼部评估和眼眶 MRI 检查。结果 激素参数之间没有发现差异，B 组和 A 组的甲状腺超声衍生参数和促甲状腺激素 (TSH) 受体 (TSH-R) 抗体 (TRAb) 水平。B 组通过 MRI 评估的 LG 疝 (LGH) 测量值显着更高右眼（10.1 (7.3-17) vs. 7 (0-3.4) mm；p = 0.004）和左眼（8.5 (6.6-13) vs. 5.8 (0-12) mm；p = 0.026）眼比组A. 在 TRAb 和 LGH 疝之间发现正相关（Rho 0.462，p = 0.009）。结论 LGH 的测量似乎是疾病和 GO 活动的良好标志物。要点 • 泪腺突出是与疾病活动相关的简单指标 • 泪腺突出与 TRAb 水平相关 • 泪腺评估可用于区分疾病早期的活动性和非活动性 Graves 眼病。B 组和 A 组中的促甲状腺激素 (TSH) 受体 (TSH-R) 抗体 (TRAb) 水平。通过 MRI 评估的 LG 疝 (LGH) 测量值在 B 组中显着更高 (10.1 ( 7.3-17) vs. 7 (0-3.4) mm; p = 0.004) 和左眼 (8.5 (6.6-13) vs. 5.8 (0-12) mm; p = 0.026) 眼比 A 组正相关在 TRAb 和 LGH 疝之间发现（Rho 0.462，p = 0.009）。结论 LGH 的测量似乎是疾病和 GO 活动的良好标志物。要点 • 泪腺突出是与疾病活动相关的简单指标 • 泪腺突出与 TRAb 水平相关 • 泪腺评估可用于区分疾病早期的活动性和非活动性 Graves 眼病。B 组和 A 组中的促甲状腺激素 (TSH) 受体 (TSH-R) 抗体 (TRAb) 水平。通过 MRI 评估的 LG 疝 (LGH) 测量值在 B 组中显着更高 (10.1 ( 7.3-17) vs. 7 (0-3.4) mm; p = 0.004) 和左眼 (8.5 (6.6-13) vs. 5.8 (0-12) mm; p = 0.026) 眼比 A 组正相关在 TRAb 和 LGH 疝之间发现（Rho 0.462，p = 0.009）。结论 LGH 的测量似乎是疾病和 GO 活动的良好标志物。要点 • 泪腺突出是与疾病活动相关的简单指标 • 泪腺突出与 TRAb 水平相关 • 泪腺评估可用于区分疾病早期的活动性和非活动性 Graves 眼病。