Rapid multiparametric quantitative MRI for predicting the activity of thyroid-associated ophthalmopathy: combination with clinical characteristics.

Objectives: To explore the feasibility of synthetic MRI (syMRI), one kind of rapid multiparametric quantitative MRI, and assess the predictive value of combining the syMRI parameters with clinical features for predicting the activity of thyroid-associated ophthalmopathy (TAO).

Materials And Methods: Clinical data and syMRI images were prospectively collected from 136 patients with TAO (72 active and 64 inactive) and 30 healthy controls. Two radiologists outlined the extraocular muscles (EOMs), orbital fat, and lacrimal glands. The clinical features and imaging parameters were compared between groups. Logistic regression analysis was used to evaluate independent risk factors of active TAO patients and establish a predictive model.

Results: Active TAO patients had significantly higher T1 relaxation time (T1RT), T2 relaxation time (T2RT), and monocyte (MONO), but significantly lower high-density lipoprotein (HDL) than inactive TAO patients (p < 0.05). Multivariate logistic regression analysis identified T1RT (OR: 1.003, p < 0.001), T2RT (OR: 1.102, p < 0.001) and HDL (OR: 0.222, p = 0.025) as independent predictors of TAO activity. Combining HDL with the T1RT and T2RT from syMRI yielded the best performance in predicting patients with active TAO (AUC: 0.884), with the sensitivity, specificity, and accuracy of 80.56%, 85.71%, and 82.35%. Second, the combination of T1RT and T2RT achieved predictive performance (AUC: 0.872), followed by T1RT (AUC: 0.804) and T2RT (AUC: 0.800), and lastly HDL (AUC: 0.636).

Conclusions: The T1RT and T2RT based on syMRI can assist in predicting TAO activity. The integration of imaging parameters from syMRI with clinical features further enhances predictive performance.

Key Points: Question The therapy for thyroid-associated ophthalmopathy (TAO) is activity-dependent. Nevertheless, clinical evaluation has shortcomings, and synthetic MRI (syMRI) can provide a quantitative foundation for assessing it. Findings T1 relaxation time (T1RT) and T2 relaxation time (T2RT) based on syMRI can effectively predict TAO activity, and the combination of them improves prediction performance. Clinical relevance The combination of T1RT and T2RT based on syMRI with clinical indicators can comprehensively assess the activity of TAO, thereby facilitating accurate and timely selection of treatments in clinical practice.