title: Diagnostic accuracy of short-time inversion recovery sequence in Graves' Ophthalmopathy before and after prednisone treatment.
abstract: BACKGROUND
  In Graves' Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS < 3) from active Graves' Ophthalmopathy (GO) (CAS > 3) subjects and, second, to follow post-steroid treatment disease.
  
  
  METHODS
  An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations.
  
  
  RESULTS
  In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness.
  
  
  CONCLUSIONS
  In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement.
authors.affiliation: Department of Clinical and Experimental Medicine and Surgery, "F. Magrassi-A. Lanzara" Second University of Naples, c/o C.T.O, Colli Aminei Street, 21, 80131, Naples, Italy, fabio.tortora@unina2.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tortora
authors.forename: Mariaevelina
authors.initials: M
authors.lastname: Prudente
authors.forename: Mario
authors.initials: M
authors.lastname: Cirillo
authors.forename: Andrea
authors.initials: A
authors.lastname: Elefante
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Belfiore
authors.forename: Francesco
authors.initials: F
authors.lastname: Romano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cappabianca
authors.forename: Carlo
authors.initials: C
authors.lastname: Carella
authors.forename: Sossio
authors.initials: S
authors.lastname: Cirillo
mesh_terms: D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D049970:Graves Ophthalmopathy / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D011241:Prednisone