Image quality and evaluation ability of magnetic resonance imaging techniques for thyroid-associated ophthalmopathy: Dixon fat-suppression technique vs. spectral attenuated inversion recovery

Kai Huang; Xiaoxin Lin; Yaosheng Luo; Qiugen Hu; Baoliang Guo; Fusheng Ouyang; Yufeng Ouyang; Cheng Song; Haixiong Chen

doi:10.3389/fmed.2023.1154828

Image quality and evaluation ability of magnetic resonance imaging techniques for thyroid-associated ophthalmopathy: Dixon fat-suppression technique vs. spectral attenuated inversion recovery

Front Med (Lausanne). 2023 Jul 12:10:1154828. doi: 10.3389/fmed.2023.1154828. eCollection 2023.

Authors

Kai Huang¹, Xiaoxin Lin¹, Yaosheng Luo², Qiugen Hu¹, Baoliang Guo¹, Fusheng Ouyang¹, Yufeng Ouyang¹, Cheng Song², Haixiong Chen¹

Affiliations

¹ Department of Radiology, Shunde Hospital, Southern Medical University, Foshan, China.
² Department of Endocrinology, Shunde Hospital, Southern Medical University, Foshan, China.

Abstract

Purpose: We aimed to compare two magnetic resonance imaging (MRI) techniques, Dixon and spectral attenuated inversion recovery (SPAIR) fat-suppression, in terms of image quality and suitability for evaluating thyroid-associated ophthalmopathy (TAO) lesion characteristics.

Methods: This cross-sectional, retrospective study involved 70 patients with TAO (140 eyes) who underwent orbital coronal MRI examinations, including Dixon-transverse relaxation (T2)-weighted imaging (T2WI) and SPAIR-T2WI, between 2020 and 2022. We compared the fat-suppression quality and artifacts, noise (N), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), signal intensity ratio (SIR) of extraocular muscles (SIR-EOM) and lacrimal glands (SIR-LG), and TAO activity evaluation efficiency.

Results: Dixon-T2WI showed a higher frequency of better subjective image quality and suitability for evaluating the characteristics of TAO lesions (65.7% vs. 14.3%) than SPAIR-T2WI. Fat-suppression quality and artifact scores were lower for Dixon-T2WI than for SPAIR-T2WI (p < 0.001). The N, SNR, and CNR values, EOM-SIR, and LG-SIR were higher for orbital coronal Dixon-T2WI than for SPAIR-T2WI (all p < 0.001). Clinical activity scores (CASs) showed positive correlations with SIR. The correlation between EOM-SIR and LG-SIR of orbital coronal Dixon-T2WI with CAS was higher than that of SPAIR-T2WI (0.590 vs. 0.493, all p < 0.001; 0.340 vs. 0.295, all p < 0.01). EOM-SIR and LG-SIR of Dixon-T2WI yielded a higher area under the curve than SPAIR-T2WI for evaluating TAO activity (0.865 vs. 0.760, p < 0.001; 0.695 vs. 0.617, p = 0.017).

Conclusion: Dixon-T2WI yields higher image quality than SPAIR-T2WI. Furthermore, it has a stronger ability to evaluate TAO inflammation than SPAIR, with higher sensitivity and specificity in active TAO staging.

Keywords: Dixon fat-suppression; MRI; image quality; lesion; spectral attenuated inversion recovery; thyroid-associated ophthalmopathy.