PMC:4666274 / 14298-17666
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4666274","sourcedb":"PMC","sourceid":"4666274","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4666274","text":"Magnetic resonance imaging analysis\nOn qualitative assessment, the mean atrophy score in patients was 1.96 ± 0.11, significantly higher than in controls (0.65 ± 0.59, p \u003c 0.001). Only two participants (both patients with CPEO) had focal STIR hyperintensity within EOMs, in 2/12 and 4/12 EOMs, respectively. Focal T1w hyperintensity was more common in patients than controls (72/108 muscles in patients, 49/108 muscles in controls, χ2 = 0.002). In patients this more commonly manifested as a streak (63 muscles) than a dot (nine muscles), whereas in the controls the counts were 25 and 24, respectively (Fig. 2A, 2B, 2C, 2D; Table 4).\nFig. 2 MRI of the orbits in the coronal plane displaying a healthy control on the left column (panels A, C, E, G, I) and a patient with chronic progressive external ophthalmoplegia (CPEO) on the right column (panels B, D, F, H, J). Coronal T1-weighted (panels A and B) and corresponding short-tau inversion recovery (STIR, panels C and D) sequences demonstrate T1-weighted hyperintense and STIR-suppressed foci intrinsic to the extra-ocular muscles (EOMs). If the diameter of the focus was approximately equal in all dimensions in the coronal plane it was termed a 'dot’, whilst if unequal it was termed a 'streak’. An example of a ‘dot’ is demonstrated in the right inferior rectus muscle on paired panels A and C, and examples of ‘streaks’ are shown in both lateral recti on paired panels B and D respectively (arrows). Panels E and F demonstrate an example of the regions of interest (ROI) used to calculate the surface area of each of the EOMs within the right orbit in a control volunteer and CPEO patient respectively: superior-rectus levator complex (SR); superior oblique (SO); medial rectus (MR); lateral rectus (LR); and inferior rectus (IR). Central ROI were placed within the same muscles for the T2-relaxometry measurements in order to avoid contamination by the surrounding fat, as demonstrated in panels G and H within the right orbits of a control volunteer and CPEO patient respectively. Panels I and J demonstrate false colour T2-relaxometry maps\nTable 4 Frequency of T1-weighted magnetic resonance imaging changes in healthy control and patient extra-ocular muscles\nControls Patients\nMuscle None Dot Streak None Dot Streak\nSR 16 2 0 7 0 11\nIR 4 2 12 8 0 10\nSO 0 14 4 4 6 8\nMR 8 4 6 0 0 18\nLR 13 2 3 3 2 13\nIO 18 0 0 14 1 3\nTotal 59 24 25 36 9 63\nLeft and right eye combined\nIO inferior oblique, IR inferior rectus, LR lateral rectus, MR medial rectus, SO superior oblique, SR superior rectus\nThe mean EOM cross-sectional area in patients was 43 % lower than for controls (patient 19.2 ± 3.9 mm2, control 33.6 ± 3.1 mm2, p \u003c 0.001; Fig. 2E and F; Table 3). Muscle T2s were greater in the patient group than controls (75.6 ± 7.0 ms, vs. 55.2 ± 4.1 ms respectively, p \u003c 0.001; Fig. 2G, h, J; Table 3). Consistent individual EOM cross-sectional area and T2 differences were observed (Fig. 1B and C). Quantitative differences in mean ROEM, EOM cross-sectional area and T2 were consistently significant when each muscle was assessed individually (all p \u003c 0.01). There was no significant quantitative difference in EOM cross-sectional area and T2 detected between the right and left orbit in either patients or controls, or between the CPEO and KSS subgroups, when muscles were compared both individually and collectively.","divisions":[{"label":"title","span":{"begin":0,"end":35}},{"label":"p","span":{"begin":36,"end":2545}},{"label":"figure","span":{"begin":634,"end":2098}},{"label":"label","span":{"begin":634,"end":640}},{"label":"caption","span":{"begin":641,"end":2098}},{"label":"p","span":{"begin":641,"end":2098}},{"label":"table-wrap","span":{"begin":2099,"end":2545}},{"label":"label","span":{"begin":2099,"end":2106}},{"label":"caption","span":{"begin":2107,"end":2218}},{"label":"p","span":{"begin":2107,"end":2218}},{"label":"table","span":{"begin":2219,"end":2398}},{"label":"tr","span":{"begin":2219,"end":2236}},{"label":"th","span":{"begin":2219,"end":2227}},{"label":"th","span":{"begin":2228,"end":2236}},{"label":"tr","span":{"begin":2237,"end":2275}},{"label":"td","span":{"begin":2237,"end":2243}},{"label":"td","span":{"begin":2244,"end":2248}},{"label":"td","span":{"begin":2249,"end":2252}},{"label":"td","span":{"begin":2253,"end":2259}},{"label":"td","span":{"begin":2260,"end":2264}},{"label":"td","span":{"begin":2265,"end":2268}},{"label":"td","span":{"begin":2269,"end":2275}},{"label":"tr","span":{"begin":2276,"end":2292}},{"label":"td","span":{"begin":2276,"end":2278}},{"label":"td","span":{"begin":2279,"end":2281}},{"label":"td","span":{"begin":2282,"end":2283}},{"label":"td","span":{"begin":2284,"end":2285}},{"label":"td","span":{"begin":2286,"end":2287}},{"label":"td","span":{"begin":2288,"end":2289}},{"label":"td","span":{"begin":2290,"end":2292}},{"label":"tr","span":{"begin":2293,"end":2309}},{"label":"td","span":{"begin":2293,"end":2295}},{"label":"td","span":{"begin":2296,"end":2297}},{"label":"td","span":{"begin":2298,"end":2299}},{"label":"td","span":{"begin":2300,"end":2302}},{"label":"td","span":{"begin":2303,"end":2304}},{"label":"td","span":{"begin":2305,"end":2306}},{"label":"td","span":{"begin":2307,"end":2309}},{"label":"tr","span":{"begin":2310,"end":2325}},{"label":"td","span":{"begin":2310,"end":2312}},{"label":"td","span":{"begin":2313,"end":2314}},{"label":"td","span":{"begin":2315,"end":2317}},{"label":"td","span":{"begin":2318,"end":2319}},{"label":"td","span":{"begin":2320,"end":2321}},{"label":"td","span":{"begin":2322,"end":2323}},{"label":"td","span":{"begin":2324,"end":2325}},{"label":"tr","span":{"begin":2326,"end":2341}},{"label":"td","span":{"begin":2326,"end":2328}},{"label":"td","span":{"begin":2329,"end":2330}},{"label":"td","span":{"begin":2331,"end":2332}},{"label":"td","span":{"begin":2333,"end":2334}},{"label":"td","span":{"begin":2335,"end":2336}},{"label":"td","span":{"begin":2337,"end":2338}},{"label":"td","span":{"begin":2339,"end":2341}},{"label":"tr","span":{"begin":2342,"end":2358}},{"label":"td","span":{"begin":2342,"end":2344}},{"label":"td","span":{"begin":2345,"end":2347}},{"label":"td","span":{"begin":2348,"end":2349}},{"label":"td","span":{"begin":2350,"end":2351}},{"label":"td","span":{"begin":2352,"end":2353}},{"label":"td","span":{"begin":2354,"end":2355}},{"label":"td","span":{"begin":2356,"end":2358}},{"label":"tr","span":{"begin":2359,"end":2375}},{"label":"td","span":{"begin":2359,"end":2361}},{"label":"td","span":{"begin":2362,"end":2364}},{"label":"td","span":{"begin":2365,"end":2366}},{"label":"td","span":{"begin":2367,"end":2368}},{"label":"td","span":{"begin":2369,"end":2371}},{"label":"td","span":{"begin":2372,"end":2373}},{"label":"td","span":{"begin":2374,"end":2375}},{"label":"tr","span":{"begin":2376,"end":2398}},{"label":"td","span":{"begin":2376,"end":2381}},{"label":"td","span":{"begin":2382,"end":2384}},{"label":"td","span":{"begin":2385,"end":2387}},{"label":"td","span":{"begin":2388,"end":2390}},{"label":"td","span":{"begin":2391,"end":2393}},{"label":"td","span":{"begin":2394,"end":2395}},{"label":"td","span":{"begin":2396,"end":2398}},{"label":"table-wrap-foot","span":{"begin":2399,"end":2545}},{"label":"p","span":{"begin":2399,"end":2426}},{"label":"p","span":{"begin":2427,"end":2545}}],"tracks":[]}