医学影像学评估甲状腺相关性眼病活动度的价值

甲状腺相关性眼病（thyroid associated ophthalmopathy，TAO）是一种器官特异性自身免疫性疾病，其治疗方案的确定及疗效观察依赖于临床活动度的评估。临床多以临床活动度评分（clinical activity score，CAS）作为TAO活动度的评价标准，但有一定的局限性。CT成像眼外肌形态学的定量分析（眼外肌总横截面积/眼眶面积比值）结果与CAS评分呈正相关；通过眼外肌T2 mapping MRI定量分析提示眼外肌T2值与TAO免疫抑制疗效密切相关，有助于评估TAO免疫抑制疗效； 99mTc-DTPA 眼眶SPECT/CT采用图像融合技术，一次显像可获得功能信息与解剖信息，可作为CAS的有效补充。现代医学影像学特别是功能影像学对TAO活动度的评估具有较大的应用价值。（眼科，2018, 27： 321-324）

The value of imaging in evaluating disease activity of thyroid associated ophthalmopathy

Thyroid-associated ophthalmopathy (TAO) is an organ-specific autoimmune disease. Clinical activity score (CAS) is often used for the assessment of disease activity in TAO, but it has certain limitations. The morphology of extraocular muscles（orbital extraocular muscle coronal area/total orbit coronal area ratio，OM/TOA ratio）in compated tomography (CT) imaging were positively correlated with CAS. Quantitative analysis of T2 mapping magnetic resonance imaging (MRI) of extraocular muscle indicated that T2 value of extraocular muscle was closely related to the effect of immunosuppression, which was helpful for evaluating the effect of immunosuppression treatment. SPECT/CT using 99mTc-DTPA for the assessment of disease activity in TAO, which can obtain functional information and anatomical information in one imaging. It can be used as an effective complement to CAS. Modern medical imaging, especially functional imaging, has great application value in evaluating disease activity of TAO. （Ophthalmol CHN， 2018, 27： 321-324）