Diagnostic Significance of Msct Orbits in Determining the Activity of Graves’ Orbitopathy

The purpose: the study of the diagnostic significance of computed tomography (CT) orbital parameters - density retrobulbar fat (RBF) and extraocular muscle (EOM) - in determining the clinical activity of the Graves’ orbitopathy. Material and methods. 102 patients with the Graves’ orbitopathy (204 eye), including 72 (70.6%) women and 30 (29.4%) men, were examined. The average age of the surveyed was 48.4 ± 12,2 years. Activity and severity of the Graves’ orbitopathy was determined according to the protocol EUGOGO. The clinical significance of multi-slice computed tomography (MSCT) orbits was evaluated on the criteria of sensitivity and specificity. We expected that the value of the cut-off threshold studied attributes by constructing ROC-curve (Receiver Operating Characteristic) using a statistical analysis program MedCalc we also used an indicator AUC (Area Under Curve, the area under the ROC-curve). Results. In the group of patients with EOC sensitivity MSCT orbits to determine the activity of the process by densitometric density of RBF and EOM was 93.9% and 44.3%, respectively; for determining fibrosis - 84.6% and 67.7%, respectively. Specificity of MSCT study of RBF and EOM density for activity the Graves’ orbitopathy was 100% for both parameters, for fibrosis - 88.9% and 94.7%, respectively. Conclusion. RBF and EOM density according to MSCT of orbits can provide additional data on the activity of the process in relation to the clinical picture of the Graves’ orbitopathy. In diagnostics, edema and infiltration respective active step of the process and the formation of fibrosis in the inactive phase is the Graves’ orbitopathy, is the most sensitive parameter of the density of the RBF. In the active phase of the disease absolute specificity has both CT-parameter. In the inactive stage the Graves’ orbitopathy highly specific test is to measure the density of the EOM.

эндокринная офтальмопатия, МСКТ орбит, чувствительность, специфичность, Graves’ orbitopathy, multi-slice computed tomography, sensitivity, specificity

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