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Quantitative T1 mapping MRI for the assessment of extraocular muscle fibrosis in thyroid-associated ophthalmopathy

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Abstract

Purpose

We aimed to investigate the performance of T1 mapping and its histological correlation with extraocular muscle fibrosis in thyroid-associated ophthalmopathy (TAO).

Methods

We prospectively recruited 12 cases of active TAO, 12 cases of inactive TAO, and 15 cases of control subjects. All participants underwent magnetic resonance imaging (MRI) scan with pre-/postcontrast T1 mapping and short-time inversion-recovery (STIR) sequence. The images were analyzed to obtain precontrast T1, extracellular-volume (ECV) fraction on T1 mapping, and signal-intensity ratio (SIR) on STIR for each rectus. Muscle biopsy was performed at lateral rectus to quantify-collagen volume fraction, glycosaminoglycan (GAG)-volume fraction, and extracellular space component. The relationship between MRI and histopathology was examined with Pearson correlation coefficient.

Results

The active TAO group was characterized with GAG accumulation, while the inactive TAO group presented with substantial fibrosis. The MRI parameters achieved acceptable interobserver and intraobserver agreement. The precontrast T1 and ECV remarkably increased in the TAO groups than the control group, and ECV positively correlated with collagen-volume fraction (r = 0.913) and extracellular-space component (r = 0.886) in the inactive TAO group. The SIR statistically increased in the active TAO group, and SIR positively correlated with GAG-volume fraction in all three groups. The performance of ECV (cutoff > 48.1%) to screen out extraocular muscle fibrosis in inactive TAO was 60.9% sensitivity and 93.3% specificity.

Conclusions

The ECV parameter on T1 mapping MRI is a reliable tool to quantify extraocular muscle fibrosis, providing insights into noninvasive evaluation of pathological changes in TAO orbit.

Trial registration number

ChiCTR2000040394; Date of registration: 28 November 2020

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Data availability

The datasets generated and analyzed during the present study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors gratefully thank Dr Rui Zhang (Fudan Eye & ENT Hospital), Dr Yanqing Zhang (Fudan Eye & ENT Hospital), and Dr Yifei Yuan (Fudan Eye & ENT Hospital) for providing control cases.

Authors’ contributions

R.M. and YG conceived and designed the study. R.M., Y.G., L.G., and Z.P. performed the study. Y.G., J.C., and J.G. analyzed the data. J.G. and J.Q. supervised the study. R.M. and Y.G. wrote the paper. All authors revised the final version of the paper. J.Q. is the principal investigator of this work and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This work was supported by the National Natural Science Foundation of China (grant number 82000940, 81970835, 81800867) and the Natural Science Foundation of Shanghai (grant number 20ZR1409500).

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Author notes

  1. These authors contributed equally: Ruiqi Ma, Yue Geng

Authors and Affiliations

  1. Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China

    Ruiqi Ma, Lu Gan, Zhiyu Peng, Jinwei Cheng, Jie Guo & Jiang Qian

  2. Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Ruiqi Ma, Lu Gan & Zhiyu Peng

  3. NHC Key Laboratory of Myopia, Fudan University, Shanghai, China

    Ruiqi Ma, Lu Gan & Zhiyu Peng

  4. Department of Radiology, Fudan Eye & ENT Hospital, Shanghai, China

    Yue Geng

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  1. Ruiqi Ma
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Correspondence to Jie Guo or Jiang Qian.

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The authors declare no competing interests.

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Approval was obtained from the ethics committee of Fudan Eye & ENT Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki

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Informed consent was obtained from all individual participants included in the study.

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Ma, R., Geng, Y., Gan, L. et al. Quantitative T1 mapping MRI for the assessment of extraocular muscle fibrosis in thyroid-associated ophthalmopathy. Endocrine 75, 456–464 (2022). https://doi.org/10.1007/s12020-021-02873-0

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  • DOI: https://doi.org/10.1007/s12020-021-02873-0

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