The combination of T2-mapping value of lacrimal gland and clinical indicators can improve the stage prediction of Graves’ ophthalmopathy compared to clinical activity scores

Purpose: To explore radiological changes of the lacrimal gland (LG) in Graves’ ophthalmopathy (GO) and whether a combination of MRI parameters and clinical indicators can better predict individual clinical manifestation of GO compared to clinical activity scores (CAS) assessment. Methods A total of 28 patients with GO (56 eyes) were enrolled between July 2020 and July 2021. Patients were classified into either the active GO group ( CAS ≥ 3) and the inactive GO group ( CAS < 3). MRI data and clinical data of LG were collected. The diagnostic performance of MRI parameters and models was assessed by receiver operating characteristic curve analysis. Logistic regression predictive models for staging GO were compared. Results There were statistically significant differences in T2-mapping values (p < 0.001), the proportion of mild or no obvious redness of conjunctival (p < 0.001), and the proportion of swelling of caruncle or plica (p < 0.001) between inactive and active groups. In MRI based logistic regression model, the T2-mapping value was an independent risk factor (AUC = 0.832). When combining MRI and clinical indicators, T2-mapping value and age resulted as independent risk factors (AUC = 0.928). Swelling of eyelids, redness of conjunctiva, swelling of conjunctiva, swelling of caruncle or plica, and spontaneous retrobulbar pain can be replaced by other objective indicators (AUC = 0.937, 0.852, 0.876, 0.896, and 0.891, respectively). Conclusion The combination of the T2-mapping value of LG and clinical indicators can improve the stage prediction of Graves’ ophthalmopathy compared to CAS and provide a new idea for improving the objectification level of GO data collection.