Resumo

RODRIGUEZ-GONZALEZ, N. et al. Short-tau inversion-recovery (STIR) sequence magnetic resonance imaging evaluation of orbital structures in Graves' orbitopathy. Arch Soc Esp Oftalmol [online]. 2011, vol.86, n.11, pp.351-357. ISSN 0365-6691.

Objective: To evaluate the orbital structures and to establish correlations with disease activity and severity in patients with Graves' hyperthyroidism and orbitopathy (GO) using short-tau inversion-recovery (STIR) sequence magnetic resonance imaging (MRI). Methods: Observational, cross-sectional, case-control study. Twenty-eight patients with euthyroid status after treatment and GO (GO group) and 15 control subjects (control group) were included. Patients underwent a complete ophthalmologic examination and were then assessed according to the EUGOGO (European Group on Graves' Orbitopathy) recommendations. Muscle cross-sectional areas, orbital tissue volumes and the signal intensity ratio (SIR) from the most inflamed extraocular muscle were calculated using a STIR-T2 weighted sequence MRI. Correlations between clinical and MRI measurements were analyzed. Results: Enlargements in the cross-sectional areas and volumes were significant for most EOMs (P<.001), but not for the lateral rectus muscle cross-sectional area. A significant difference in SIR values between patients with GO and control subjects (P<.001) was found. No significant correlations were found between muscle cross-sectional areas, orbital tissue volumes, SIR values and the clinical activity parameters. Conclusions: Given the small sample size of our study, with the obvious need for larger clinical trials, we were unable to demonstrate that the STIR sequences in MRI are a sensitive tool in assessing patients with longstanding GO in order to detect inflammatory changes and activity follow-up, possibly because it is in inactive phase. Meanwhile, it is still necessary to continue performing a thorough clinical evaluation in the therapeutic management of GO.

Palavras-chave : Graves' orbitopathy; Extraocular muscle; Magnetic resonance imaging; Exophthalmos; Clinical activity.

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