Novel griseofulvin zinc nanohybrid emulsion for intensifying the antimicrobial control of dermatophytes and some opportunistic pathogens.

Dermatophytosis is a critical sort of skin infection caused by dermatophytes. The long-term treatment of such skin infections may be improved through the application of nanotechnology. This study aimed to prepare griseofulvin zinc Nanohybrid emulsion (GF-Zn-NHE) to improve griseofulvin activity against dermatophytes and some opportunistic pathogenic yeasts and bacteria. The GF-Zn-NHE is prepared by ultra-homogenization ultra-sonication strategies and validated by UV-visible spectroscopy analysis that confirms presences of griseofulvin and Zn-NPs peaks at 265 and 360 nm, respectively. The GF-Zn-NHE has mean distribution size 50 nm and zeta potential in the range from -40 to -36 mV with no significant changes in size distribution and particle size within 120 day ageing. Fourier transform infrared spectroscopy spectrum confirmed the presence of griseofulvin and Zn-NPs stretching vibration peaks. Gamma ray has a negative influence on GF-Zn-NE production and stability. GF-Zn-NHE drug release 95% up to 24 h and 98% up to 72 h of GF was observed and Zinc 90% up to 24 h and 95% up to 72 h, respectively. High antimicrobial activity was observed with GF-Zn-NHE against dermatophytic pathogens in compare with GF, GF-NE, zinc nitrate and ketoconazole with inhibition zone ranged from 14 to 36 mm. The results have shown that the MIC value for Cryptococcus neoformans, Prophyromonas gingivalis and Pseudomonas aeruginosa is 0.125 mg ml -1 and for Trichophyton rubrum, L. bulgaricus and Escherichia coli value is 0.25 mg ml -1 and for Candida albicans, Malassezia furfur and Enterococcus faecalis is 0.5 mg ml -1 and finally 1 mg ml -1 for Streptococcus mutans. TEM of treated Cryptococcus neoformans cells with GF-Zn-NHE displayed essentially modified morphology, degradation, damage of organelles, vacuoles and other structures.

Role of Artificial Intelligence for Autism Diagnosis Using DTI and fMRI: A Survey.

Autism spectrum disorder (ASD) is a wide range of diseases characterized by difficulties with social skills, repetitive activities, speech, and nonverbal communication. The Centers for Disease Control (CDC) estimates that 1 in 44 American children currently suffer from ASD. The current gold standard for ASD diagnosis is based on behavior observational tests by clinicians, which suffer from being subjective and time-consuming and afford only late detection (a child must have a mental age of at least two to apply for an observation report). Alternatively, brain imaging-more specifically, magnetic resonance imaging (MRI)-has proven its ability to assist in fast, objective, and early ASD diagnosis and detection. With the recent advances in artificial intelligence (AI) and machine learning (ML) techniques, sufficient tools have been developed for both automated ASD diagnosis and early detection. More recently, the development of deep learning (DL), a young subfield of AI based on artificial neural networks (ANNs), has successfully enabled the processing of brain MRI data with improved ASD diagnostic abilities. This survey focuses on the role of AI in autism diagnostics and detection based on two basic MRI modalities: diffusion tensor imaging (DTI) and functional MRI (fMRI). In addition, the survey outlines the basic findings of DTI and fMRI in autism. Furthermore, recent techniques for ASD detection using DTI and fMRI are summarized and discussed. Finally, emerging tendencies are described. The results of this study show how useful AI is for early, subjective ASD detection and diagnosis. More AI solutions that have the potential to be used in healthcare settings will be introduced in the future.

Entomotoxic efficacy of fungus-synthesized nanoparticles against immature stages of stored bean pests.

Nanopesticides, particularly biosynthesized ones using organic reductants, hold great promise as a cost-effective and eco-friendly alternative to chemical pesticides. However, their efficacy on stored product pests, which can cause damage to dried grains, has not been extensively tested, especially on immature stages. Here, we biosynthesized six types of nanoparticles (NPs) using extracts from the fungus Fusarium solani: silver (AgNPs), selenium (SeNPs), silicon dioxide (SiO2NPs), copper oxide (CuONPs), titanium dioxide (TiO2NPs) and zinc oxide (ZnONPs) ranging in size from 8 to 33 nm. To test their efficacy on stored bean pests, they were applied to the eggs and larvae of pest beetles Callosobruchus chinensis and Callosobruchus maculatus (Coleoptera: Chrysomelidae: Bruchinae), which burrow into seeds as larvae. Susceptibility to the NPs was species-dependent and differed between developmental stages; eggs were more susceptible than larvae inhabiting in seeds. SeNPs and TiO2NPs reduced the hatchability of C. chinensis eggs by 23% and 18% compared to the control, respectively, leading to an 18% reduction in egg-to-adult survival by SeNPs. In C. maculatus, TiO2NPs applied to eggs reduced larva-to-adult survivorship by 11%, resulting in a 15% reduction in egg-to-adult survival. The egg mass of C. chinensis was 23% smaller than that of C. maculatus: the higher surface-area-to-volume ratio of the C. chinensis eggs could explain their higher acute mortality caused by the NPs compared to C. maculatus eggs. The biosynthesized SeNPs and TiO2NPs have potential for controlling major stored bean pests when applied to their eggs. This is the first to show the efficacy of biosynthesized SeNPs and TiO2NPs on stored product pests and the efficacy of Fusarium-synthesized NPs on insects.

Risk assessment supporting the establishment of a maximum residue limit for ractopamine in beef liver, applicable in the Arab Republic of Egypt.

In 2012, the Codex Alimentarius Commission adopted maximum residue limits (MRLs) for ractopamine in pig and cattle tissues. Egypt, a country that records a high consumption of beef liver, conducted a health risk assessment to estimate the risks associated with the adoption of Codex MRLs and the possible adoption of alternative values that may offer higher protection. Ractopamine was characterized based on previous assessments performed by international regulatory agencies, and an acceptable daily intake was set at 1 µg/kg bw for both chronic and acute ractopamine exposure. Beef liver consumption data for the Egyptian population were collected through a field survey (529 households, 1929 individuals). The standard body weight of 60 kg was used, as well as 70 kg, as a potentially more representative weight for the Egyptian population. Simulations showed that when the MRL for ractopamine in beef liver is set to 40 µg/kg (Codex MRL) or 20 µg/kg, the health-based guidance value of 1 µg/kg bw was not exceeded, as a result of chronic or acute exposure. An MRL of 20 µg/kg of ractopamine in beef liver was shown to provide optimum protection of Egyptian consumers, considering other potential sources of ractopamine intake and abnormally high consumption patterns, and was therefore recommended for adoption in Egypt. This study presents the inputs, model, and results of the probabilistic risk assessment that supported such recommendation. PRACTICAL APPLICATION: Residues of veterinary drugs, such as ractopamine, accumulate in animal tissues and may pose a risk to consumers. Establishing maximum residue limits (MRLs) will help importers by giving them the necessary visibility for commercial trade. It will also benefit Egyptian consumers, large consumers of beef liver, who will be better protected with a lower MRL than the internationally recommended one.

Evidence of nerve hypertrophy in patients with inclusion body myositis on lower limb MRI.

INTRODUCTION/AIMS: Inclusion body myositis (IBM) is a myopathic condition but in some patients has been associated with an axonal length-dependent polyneuropathy. In this study, we quantified the cross-sectional area of the sciatic and tibial nerves in patients with IBM comparing with Charcot-Marie-Tooth disease type 1A (CMT1A) and healthy controls using magnetic resonance neurography (MRN). METHODS: MRN of the sciatic and tibial nerves was performed at 3T using MPRAGE and Dixon acquisitions. Nerve cross-sectional area (CSA) was measured at the mid-thigh and upper third calf regions by an observer blinded to the diagnosis. Correlations were performed between these measurements and clinical data. RESULTS: A total of 20 patients with IBM, 20 CMT1A and 29 healthy controls (age- and sex-matched) were studied. Sciatic nerve CSA was significantly enlarged in patients with IBM and CMT1A compared to controls (sciatic nerve mean CSA 62.3 ± 22.9 mm2 (IBM) vs. 35.5 ± 9.9 mm2 (controls), p < 0.001; and 96.9 ± 35.5 mm2 (CMT1A) vs. 35.5 ± 9.9 mm2 (controls); p < 0.001). Tibial nerve CSA was also enlarged in IBM and CMT1 patients compared to controls. DISCUSSION: MRN reveals significant hypertrophy of the sciatic and tibial nerves in patients with IBM and CMT1A compared to controls. Further studies are needed to correlate with neurophysiological measures and assess whether this finding is useful diagnostically.

Artificial Intelligence and Deep Learning of Head and Neck Cancer.

Artificial intelligence (AI) algorithms, particularly deep learning, have developed to the point that they can be applied in image recognition tasks. The use of AI in medical imaging can guide radiologists to more accurate image interpretation and diagnosis in radiology. The software will provide data that we cannot extract from the images. The rapid development in computational capabilities supports the wide applications of AI in a range of cancers. Among those are its widespread applications in head and neck cancer.

Diffusion Tensor Imaging in Characterization of Mediastinal Lymphadenopathy.

OBJECTIVE: To determine the efficacy of diffusion-weighted MRI (DWI) and diffusion tensor imaging (DTI) in the characterization of mediastinal lymphadenopathy and the differentiation between malignant and benign lymph nodes (LNs). METHODS: a retrospective evaluation of 58 patients with mediastinal lymphadenopathy that underwent DWI and DTI with calculation of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and mean diffusivity (MD) values of LNs. Final diagnosis was made by the histopathology and proved metastatic (n = 21), lymphomatous (n = 14), granulomatous (n = 11) and reactive (n = 12) LNs. RESULTS: Malignant mediastinal LNs had remarkably lower ADC and MD; (p = 0.001) and higher FA; (p = 0.001) than in benign LNs. The threshold of ADC, MD, and FA at (1.48, 1.32 × 10-3 mm2/s), (1.31, 1.33 × 10-3 mm2/s), (0.62, 0.52) to differentiate malignant from benign LNs has AUC of (0.89, 0.94), (0.96, 0.95), (0.72, 0.82), accuracy of (87%, 86%), (89%, 86%), (70%, 72%) by both observers respectively. The threshold of ADC, MD, and FA at (1.47, 1.32 × 10-3 mm2/s), (1.31, 1.3 × 10-3 mm2/s), (0.62, 0.67) used to differentiate metastatic from reactive LNs revealed AUC of (0.90, 0.94), (0.96, 0.96), (0.73, 0.77), accuracy of (87%, 81%), (87%, 81%), (72%, 66%) by both observers respectively. The mean ADC and MD values of metastatic LNs were statistically significant (p = 0.001) and (p = 0.002, 0.02) respectively when compared with that of lymphoma. The threshold of ADC, and MD (0.94, 0.97 × 10-3 mm2/s) and (0.87, 0.91 × 10-3 mm2/s) used to differentiates metastatic from lymphomatous nodes revealed AUC of (0.90, 0.91), (0.81, 0.74), an accuracy of (85%, 91%), (71%, 71%), by both observers respectively. The inter-class correlation between two observers for all nodes for ADC, MD and FA was r= 0.931, 0.956 and 0.885 respectively. CONCLUSION: Using ADC, MD, and FA can help in the characterization of mediastinal lymphadenopathy noninvasively.

Clinical applications of artificial intelligence and radiomics in neuro-oncology imaging.

This article is a comprehensive review of the basic background, technique, and clinical applications of artificial intelligence (AI) and radiomics in the field of neuro-oncology. A variety of AI and radiomics utilized conventional and advanced techniques to differentiate brain tumors from non-neoplastic lesions such as inflammatory and demyelinating brain lesions. It is used in the diagnosis of gliomas and discrimination of gliomas from lymphomas and metastasis. Also, semiautomated and automated tumor segmentation has been developed for radiotherapy planning and follow-up. It has a role in the grading, prediction of treatment response, and prognosis of gliomas. Radiogenomics allowed the connection of the imaging phenotype of the tumor to its molecular environment. In addition, AI is applied for the assessment of extra-axial brain tumors and pediatric tumors with high performance in tumor detection, classification, and stratification of patient's prognoses.

Silica nanoparticles as pesticide against insects of different feeding types and their non-target attraction of predators.

The agricultural use of silica (SiO2) nanoparticles (NPs) has the potential to control insect pests while the safety and tritrophic effects on plants and beneficial natural enemies remains unknown. Here, we evaluate the effects of silica NPs on insect pests with different feeding niches, natural enemies, and a plant. Silica NPs were applied at different concentrations (75-425 mg/L) on field-cultivated faba bean and soybean for two growing seasons. The faba bean pests, the cowpea aphid Aphis craccivora and the American serpentine leafminer Liriomyza trifolii, and the soybean pest, the cotton leafworm Spodoptera littoralis, were monitored along with their associated predators. Additional laboratory experiments were performed to test the effects of silica NPs on the growth of faba bean seedlings and to determine whether the rove beetle Paederus fuscipes is attracted to cotton leafworm-infested soybean treated with silica NPs. In the field experiments, silica NPs reduced the populations of all three insect pests and their associated predators, including rove beetles, as the concentration of silica NPs increased. In soybean fields, however, the total number of predators initially increased after applying the lowest concentration. An olfactometer-based choice test found that rove beetles were more likely to move towards an herbivore-infested plant treated with silica NPs than to a water-treated control, suggesting that silica NPs enhance the attraction of natural enemies via herbivore-induced plant volatiles. In the laboratory, while silica NPs inhibited the development of faba bean roots at 400 mg/L, they did not affect germination percentage, germination time, shoot length, or vigor index compared to the control.

De novo Portal Vein Thrombosis in Non-Cirrhotic Non-Alcoholic Fatty Liver Disease: A 9-Year Prospective Cohort Study.

Background and Aims: Approximately 30-40% of portal vein thrombosis (PVT) remains of unknown origin. The association between non-alcoholic fatty liver disease (NAFLD) and PVT is a matter of debate. This study aimed to investigate the association between PVT and NAFLD. Methods: We included 94 out of 105 consecutive NAFLD patients in this prospective cohort study in addition to 94 from the healthy control group. We evaluated biochemical, clinical, immunological, and histopathological parameters; waist circumference (WC); leptin; adiponectin; and leptin/adiponectin ratio (LAR) for all participants at baseline and every 3 years thereafter. We described the characteristics of participants at baseline and showed individual WC, LAR, and PVT characteristics. Potential parameters to predict PVT development within 9 years were determined. Results: PVT developed in eight (8.5%) patients, mainly in the portal trunk. Univariate analysis showed three PVT-associated factors: diabetes mellitus (P = 0.013), WC (P < 0.001), and LAR (P = 0.002). After adjusting multiple confounding variables, the multivariate model showed that the only significant variables were WC and LAR. By applying the receiver operating characteristic curve, WC had 98.8% specificity, 87.5% sensitivity, and 0.894 area under the curve (AUC) for prediction of PVT (P < 0.001) at cutoff values of > 105 cm. In comparison, LAR had 60.5% specificity, 87.5% sensitivity, and 0.805 AUC for PVT prediction (P < 0.001) at cutoff values of >7.5. Conclusions: This study suggests that increased central obesity and LAR were independently associated with PVT development in non-cirrhotic NAFLD patients, and they should be considered risk factors that may participate in PVT multifactorial pathogenesis.

Interactive Effects of Biosynthesized Nanocomposites and Their Antimicrobial and Cytotoxic Potentials.

The present study investigated the biosynthesis of silver (AgNPs), zinc oxide (ZnONPs) and titanium dioxide (TiO2NPs) nanoparticles using Aspergillusoryzae, Aspergillusterreus and Fusariumoxysporum. Nanocomposites (NCs) were successfully synthesized by mixing nanoparticles using a Sonic Vibra-Cell VC/VCX processor. A number of analytical techniques were used to characterize the synthesized biological metal nanoparticles. Several experiments tested biologically synthesized metal nanoparticles and nanocomposites against two types of human pathogenic bacteria, including Gram-positive Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA), and Gram-negative Escherichia coli and Pseudomonasaeruginosa. Additionally, the antitumor activity in HCT-116 cells (colonic carcinoma) was also evaluated. Significant antimicrobial effects of various synthesized forms of nanoparticles and nanocomposites against E. coli and P. aeruginosa bacteria were detected. Various synthesized biogenic forms of nanoparticles and nanocomposite (9.0 to 29 mm in diameter) had high antibacterial activity and high antitumor activity against HCT-116 cells (colonic carcinoma) with IC50 values of 0.7-100 µg/mL. Biosynthesized NPs are considered an alternative to large-scale biosynthesized metallic nanoparticles and nanocomposites, are simple and cost effective, and provide stable nanomaterials.

Differentiation malignant from benign parotid tumors in children with diffusion-weighted MR imaging.

PURPOSE: To differentiate pediatric solid malignant from the benign parotid tumors with diffusion-weighted MR imaging (DWI). MATERIALS AND METHODS: A retrospective study comprising 38 children with parotid tumors (21 boys and 17 girls aged from 2 months to 17 years) was conducted using (DWI) of the parotid gland. Apparent diffusion coefficient (ADC) maps were generated. The ADC value of the parotid tumors was calculated. RESULTS: The mean ADC value of malignant parotid tumors (1.08 ± 0.1, 1.04 ± 0.1 × 10-3mm2/s) was significantly lower [P = 0.001] than that of benign lesions (1.69 ± 0.2, 1.72 ± 0.3 × 10-3mm2/s). A threshold of ADC of 1.40, 1.33 × 10-3mm2/s was used for differentiating malignant parotid tumors from benign lesions and led to the best results of the area under the curve of 0.940, 0.929, accuracy of 86, 89%, sensitivity of 94, 94%, specificity of 80, 85%, negative predictive value of 94.1, 94.4%, and positive predictive value of 81, 85%. There was insignificant difference in ADC values of malignant lesions (P = 0.23, 0.30) as well as within benign lesions (P = 0.25, 0.08). CONCLUSION: DWI is an innovative anticipating imaging technique that can be used in the differentiation of pediatric solid malignant parotid tumors from benign lesions.

Imaging of congenital cranial dysinnervation disorders: What radiologist wants to know?

We aim to review the imaging features of congenital cranial dysinnervation disorders. Characteristic imaging findings can define subtypes of these disorders through assessment of cranial nerves, extraocular muscles, orbital, and brain abnormalities. Duane retraction syndrome shows absent or hypoplasic 6th cranial nerve and preserved extraocular muscles (EOM). Mobius syndrome shows absent 7th and 6th cranial nerves, absence of facial colliculus, flattening of the dorsal aspect of the pons, hypoplasia of the pons and medulla, and flattening of the 4th ventricular floor. Congenital fibrosis of the extraocular muscles reveals unilateral or bilateral hypoplasia or aplasia of the 3rd cranial nerve, atrophy of superior rectus and levator palpebrae superioris muscles, and atrophy of the brainstem and cerebellar hemispheres. Horizontal gaze palsy and progressive scoliosis show characteristic split pons sign, butterfly medulla, absent facial colliculi, and spinal scoliosis. HOXA1 Mutations show a bilateral absence of 6th cranial nerves with the underdeveloped inner ear. Pontine Cap Tegmental Dysplasia shows ventral pontine hypoplasia, dorsal tegmental projection into the 4th ventricle, and variable cranial nerve deficits.

Multi-parametric arterial spin labeling and diffusion-weighted imaging in differentiation of metastatic from reactive lymph nodes in head and neck squamous cell carcinoma.

PURPOSE: To assess arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) in the differentiation of metastatic from reactive lymph nodes (LNs) in head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: Retrospective analysis of 113 LNs in 43 patients with HNSCC underwent ASL and DWI of the neck. The tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the cervical LNs were calculated. The final diagnosis of metastatic (n = 82) and reactive (n = 31) was proved with the pathological examination. RESULTS: The TBF of metastatic LNs (58.8 ± 10.2, 58.6 ± 8.5 mL/100 g/min) was significantly higher (p = 0.001) than the reactive LNs (23.2 ± 10.3, 28.2 ± 16.7 mL/100 g/min) for both observers, respectively. The ADC of metastatic LN (1.12 ± 0.07, 1.21 ± 0.07 × 10-3mm2/s) was significantly lower (p = 0.001) than reactive LN (1.41 ± 0.09, 1.44 ± 0.14 × 10-3mm2/s) for both observers, respectively. The threshold of TBF (> 39.5, 40.5 mL/100 g/min), ADC (≥ 1.31, 1.30 X10-3mm2/s) and combined parameters for both observers, respectively, used for differentiating metastatic from reactive LNs revealed an area under the curve of (0.94, 0.945), (0.90, 0.931), and (0.98, 0.989), an accuracy of (88.6%, 80.5%), (80.0%, 88.5%), and (94.3%, 98.2), respectively. CONCLUSION: Combined TBF and ADC are non-invasive imaging parameters that can play a role in differentiation metastatic from reactive LNs in patients with HNSCC.

Arterial spin labeling and diffusion-weighted MR imaging: Utility in differentiating idiopathic orbital inflammatory pseudotumor from orbital lymphoma.

PURPOSE: To assess arterial spin-labeling (ASL) and diffusion-weighted imaging (DWI) and in combination for differentiating between idiopathic orbital inflammatory pseudotumor (IOIP) and orbital lymphoma. MATERIAL AND METHODS: A retrospective study was done on 37 untreated patients with orbital masses, suspected to be IOIP or orbital lymphoma that underwent ASL and DWI of the orbit. Quantitative measurement of tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the orbital lesion was done. RESULTS: There was a significant difference (P = 0.001) in TBF between patients with IOIP (n = 21) (38.1 ± 6.2, 40.3 ± 7.1 ml/100 g/min) and orbital lymphoma (n = 16) (55.5 ± 7.1, 56.8 ± 7.9 ml/100 g/min) for both observers respectively. Thresholds of TBF used for differentiating IOIP from orbital lymphoma were 48, 46 ml/100 g/min revealed area under the curve (AUC) of (0.958 and 0.921), and accuracy of (86% and 83%) for both observers respectively. There was a significant difference (P = 0.001) in ADC between patients with IOIP (1.04 ± 0.19, 1.12 ± 0.23 × 10-3 mm2/s) and orbital lymphoma (0.69 ± 0.10, 0.72 ± 0.11 × 10-3 mm2/s) for both observers respectively. Thresholds of ADC used for differentiating IOIP from orbital lymphoma were 0.84 and 0.86 × 10-3 mm2/s with AUC of (0.933 and 0.920), and accuracy of 89% and 90% for both observers respectively. The combined TBF and ADC used for differentiating IOIP from orbital lymphoma had AUC of (0.973 and 0.970) and accuracy of (91% and 89%) for both observers respectively. CONCLUSION: TBF and ADC alone and in combination are useful for differentiating IOIP from orbital lymphoma.

Multidetector computed tomography evaluation of synchronous lymphoma and other solid malignancies.

OBJECTIVE: The objective of this study is to review the multidetector computed tomography (MDCT) findings of synchronous lymphoma and other solid malignancies. PATIENTS AND METHODS: This retrospective study included 18 patients confirmed with diagnosis of lymphoma and other solid malignancies. They were 8 women and 10 men (mean age, 62.5 year; range, 44-73 years). CT scanning was performed on one of the two systems: 64 MDCT in 11 patients and 6 MDCT in 7 patients. All 36 malignancies were underwent pathological evaluation. RESULTS: All cases were confirmed pathologically. Lymphomas were Hodgkin disease ( n = 5 patients) and non-Hodgkin lymphoma ( n = 13 patients). Hepatocellular carcinoma was detected in five patients. Bronchogenic carcinoma was detected in two patients. Renal cell carcinoma was detected in two patients. Breast carcinoma was detected in two patients. Prostatic carcinoma was detected in two patients. Gastric carcinoma was detected in two patients. Endometrial carcinoma was detected in one patient. Colonic carcinoma was detected in one patient. Thyroid carcinoma was detected in one patient. CONCLUSIONS: MDCT scanning is accurately imaging modality for the evaluation of synchronous lymphoma and other solid malignancies. More reports and accumulation of such cases should help to clarify the mechanisms, contribute to a further understanding of this phenomenon, and may lead to a new treatment strategy for synchronous lymphoma and other solid malignancies.

Diffusion Tensor Imaging of the Lateral Rectus Muscle in Duane Retraction Syndrome.

AIM: This study aimed to assess metrics of diffusion tensor imaging in evaluating microstructural abnormalities of the lateral rectus muscle in Duane retraction syndrome (DRS). PATIENT AND METHODS: A prospective study was conducted on 27 patients with DRS and 16 age- and sex-matched controls who underwent diffusion tensor imaging of orbit and forced duction test (FDT). Fractional anisotropy (FA) and mean diffusivity (MD) of the lateral rectus were calculated by 2 observers. RESULTS: Fractional anisotropy of the lateral rectus in patients (0.62 ± 0.07 and 0.59 ± 0.06) was significantly higher (P = 0.001) than that in controls (0.49 ± 0.06 and 0.51 ± 0.06). Selection values of 0.53 and 0.52 as cutoff points of FA of the lateral rectus to differentiate patients from controls revealed areas under the curve of 0.92 and 0.86 and accuracy values of 84.8% and 80.4% by both observers, respectively. Mean diffusivity of the lateral rectus by both observers in patients (1.19 ± 0.13 and 1.23 ± 0.19 × 10 mm/s) was significantly lower (P = 0.001) than that in controls (1.54 ± 0.18 and 1.49 ± 0.16 × 10 mm/s). Selection values of 1.35 and 1.40 × 10 mm/s as cutoff points of MD of the lateral rectus to differentiate patients from the control groups revealed areas under the curve of 0.93 and 0.85 and accuracy values of 91.3% and 80.4% by both observers, respectively. Interobserver agreement for MD and FA of the lateral rectus by both observers were excellent (r = 0.870 and, 0.959). Diffusion tensor imaging metrics of the lateral rectus muscle did not differ significantly between patients with unilateral and bilateral disease (P = 0.05) and patients with DRS type I and type III (P = 0.05). Diffusion tensor imaging metrics of the lateral rectus muscle differed significantly between FDT grades I and II versus grades III and IV, and these metrics were well correlated with the degree of FDT. CONCLUSION: Diffusion tensor imaging metrics are valuable noninvasive tools in evaluating the microstructural abnormalities of the lateral rectus in DRS and are well correlated with degree of FDT.