Diffusion-weighted magnetic resonance imaging of extraocular muscles in patients with Grave's ophthalmopathy using turbo field echo with diffusion-sensitized driven-equilibrium preparation

Purpose: The purpose of this study was to correlate diffusivity of extraocular muscles, measured by three-dimensional turbo field echo (3DTFE) magnetic resonance (MR) imaging using diffusion-sensitized driven-equilibrium preparation, with their size and activity in patients with Grave's ophthalmopathy. Materials and methods: Twenty-three patients with Grave's ophthalmopathy were included. There were 17 women and 6 men with a mean age of 55.8 ± 12.6 (SD) years (range: 26–83 years). 3DTFE with diffusion-sensitized driven-equilibrium MR images were obtained with b-values of 0 and 500 s/mm². The apparent diffusion coefficient (ADC) of extraocular muscles was measured on coronal reformatted MR images. Signal intensities of extraocular muscles on conventional MR images were compared to those of normal-appearing white matter, and cross-sectional areas of the muscles were also measured. The clinical activity score was also evaluated. Statistical analyses were performed with Pearson correlation and Mann-Whitney U tests. Results: On 3DTFE with diffusion-sensitized driven-equilibrium preparation, the mean ADC of the extraocular muscles was 2.23 ± 0.37 (SD) × 10⁻³ mm2/s (range: 1.70 × 10⁻³–3.11 × 10⁻³ mm²/s). There was a statistically significant moderate correlation between ADC and the size of the muscles (r = 0.61). There were no statistically significant correlations between ADC and signal intensity on conventional MR and the clinical activity score. Conclusion: 3DTFE with diffusion-sensitized driven-equilibrium preparation technique allows quantifying diffusivity of extraocular muscles in patients with Grave's ophthalmopathy. The diffusivity of the extraocular muscles on 3DTFE with diffusion-sensitized driven-equilibrium preparation MR images moderately correlates with their size.