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目的探讨提上睑肌MRI改变与Graves眶病上睑迟落的相关性。设计前瞻性病例系列。研究对象20例(20眼)正常志愿者,8例(10眼)Graves眶病无上睑迟落患者,7例(10眼)上睑迟落患者。方法受检者应用眼表面线圈,于前视眼位、上视眼位及下视眼位行斜冠状面、斜矢状面T_1WI扫描。主要指标各眼位提上睑肌横截面积、厚度,腱膜上方脂肪厚度,提上睑肌收缩率、舒张率。结果正常者提上睑肌各眼位横截面积、厚度、腱膜上方脂肪厚度、收缩率、舒张率在侧别、性别及年龄间差异无统计学意义(P均>0.05)。提上睑肌在上视眼位横截面积(17.93±4.48)mm~2、厚度(2.21±0.22)mm较前视眼位增加,下视眼位横截面积(5.48±1.32)mm~2、厚度(1.11±1.15)mm较前视眼位减小(P均<0.05)。Graves眶病患者各眼位提上睑肌横截面积、厚度及腱膜上方脂肪厚度较正常者均增加,提上睑肌收缩率、舒张率均减小(P均<0.05)。迟落征患者较无迟落征患者,下视眼位提上睑肌厚度(2.74±0.71)mm及腱膜上方脂肪厚度(1.94±0.54)mm明显增加,面积舒张率0.12±0.14和厚度舒张率0.11±0.08明显减小(P均<0.05)。结论Graves眶病患者下视眼位提上睑肌厚度、舒张率及腱膜上方脂肪厚度的变化与上睑迟落关系密切。
Objective To investigate the correlation between levator muscle remodeling and Graves orbital disease. Design prospective case series. The study included 20 normal volunteers (20 eyes), 8 patients (10 eyes) with Graves orbital disease without upper eyelid late, and 7 patients with delayed upper eyelid (10 eyes). Methods The subjects applied the ocular surface coil, in the anterior eye position, the upper astigmatism and lower astigmatism were oblique coronal plane, sagittal plane T_1WI scan. The main indicators of the eye position to mention levator muscle cross-sectional area, thickness, fat thickness above the aponeurosis, levator muscle contraction rate, diastolic rate. Results There was no significant difference in laterality, sex and age between the two groups (P> 0.05). There were no significant differences in the cross sectional area and thickness of the ocular levator ani, thickness of fat above the aponeurosis, contraction rate and diastolic rate. The position of the upper levator muscle was (17.93 ± 4.48) mm ~ 2, the thickness was (2.21 ± 0.22) mm, the position of the lower eye was (5.48 ± 1.32) mm ~ 2 , While the thickness (1.11 ± 1.15) mm was lower than that of the frontal eyes (all P <0.05). Graves orbital disease in each eye position to mention levator muscle cross-sectional area, thickness and fat above the thickness of the aponeurosis than normal were increased, levator muscle contraction rate, diastolic rate were reduced (P all <0.05). In patients with late fall, there was a significant increase in the thickness of upper levator muscle (2.74 ± 0.71) mm and the fat thickness above the aponeurosis (1.94 ± 0.54) mm, with an area of relaxation of 0.12 ± 0.14 and a diastolic thickness The rate of 0.11 ± 0.08 decreased significantly (all P <0.05). Conclusions Graves orbital disease under the eye position to mention the levator muscle thickness, diastolic rate and fat above the thickness of the aponeurosis and the late upper eyelid is closely related.