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This research investigates the use of multiparametric MRI alongside clinical parameters to evaluate Graves’ ophthalmopathy.

May 11, 2026Open Access

Multiparametric MRI quantitative metrics for grading and staging graves’ ophthalmopathy

SWShaopeng WuFujian Medical University LYLibin YangFujian Medical University YCYong CaiFujian Medical University

Key Points

This research investigates the use of multiparametric MRI alongside clinical parameters to evaluate Graves’ ophthalmopathy.
Retrospective study involving 71 patients with Graves’ ophthalmopathy and 142 affected eyes.
Categorized patients into inactive/active and mild/moderate-severe groups to measure extraocular muscle parameters.
Developed combined diagnostic models using multivariate logistic regression and assessed efficacy with ROC curve.
Active and moderate-severe groups demonstrated higher EOM-SIR, EOM-T1RT, and EOM-T2RT, and lower EOM-FF (P < 0.05).
Model 3 offered an AUC of 0.912 for differentiating GO activity, while Model 6 reached AUC of 0.947 for severity assessment.
Higher TRAb levels were observed in the moderate-severe group (P < 0.05).

Abstract

Abstract Objective To explore the application of multiparametric magnetic resonance imaging (MRI) combined with clinical parameters in the assessment of Graves’ ophthalmopathy (GO). Methods This retrospective study included 71 patients with GO (142 affected eyes) categorized into inactive (75) vs. active (67) and mild (70) vs. moderate-severe (72) subgroups. Clinical parameters were collected, and extraocular muscle (EOM) parameters signal intensity ratio (SIR), T1 relaxation times (T1RT), T2 relaxation times (T2RT), and fat fraction (FF) were measured (max/mean values). Predicted probabilities were derived from the generalized linear mixed model. Multivariate Logistic regression (based on the Akaike Information Criterion) was used to develop combined diagnostic models, and the marginal area under the receiver operating characteristic (ROC) curve (AUC) was employed to assess their efficacy. Results Compared with the inactive and mild groups, the active and moderate-severe GO eyes showed higher mean EOM-SIR, mean EOM-T1RT, and mean/max EOM-T2RT, as well as lower mean/max EOM-FF and female proportion (all P < 0.05). The active group had a shorter disease duration, whereas the moderate-severe group had higher thyrotropin receptor antibody (TRAb) levels ( P < 0.05). For differentiating GO activity and severity, the combined staging Model 3 (EOM-FFmax + EOM-T1RTmean + EOM-T2RTmean + sex + thyroid functional status) and grading Model 6 (EOM-FFmax + EOM-T1RTmean + EOM-T2RTmean + sex + TRAb + thyroid functional status) yielded the best diagnostic efficacy, with AUCs of 0.912 and 0.947, respectively. Conclusion The combined model of quantitative multiparametric MRI and clinical parameters enables a more accurate assessment of GO activity and severity.

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