RESUMEN
OBJECTIVES: To determine the diagnostic performances of a single Dixon-T2-weighted imaging (WI) sequence compared to a conventional protocol including T1-, T2-, and fat-suppressed T2-weighted MRI at 3 T when assessing thyroid eye disease (TED). MATERIALS AND METHODS: This IRB-approved prospective single-center study enrolled participants presenting with confirmed TED from April 2015 to October 2019. They underwent an MRI, including a conventional protocol and a Dixon-T2WI sequence. Two neuroradiologists, blinded to all data, read both datasets independently and randomly. They assessed the presence of extraocular muscle (EOM) inflammation, enlargement, fatty degeneration, or fibrosis as well as the presence of artifacts. The Wilcoxon signed-rank test was used. RESULTS: Two hundred six participants were enrolled (135/206 [66%] women, 71/206 [34%] men, age 52.3 ± 13.2 years). Dixon-T2WI was significantly more likely to detect at least one inflamed EOM as compared to the conventional set (248/412 [60%] versus 228/412 [55%] eyes; (p = 0.02). Dixon-T2WI was more sensitive and specific than the conventional set for assessing muscular inflammation (100% versus 94.7% and 71.2% versus 68.5%, respectively). Dixon-T2WI was significantly less likely to show major or minor artifacts as compared to fat-suppressed T2WI (20/412 [5%] versus 109/412 [27%] eyes, p < 0.001, and 175/412 [42%] versus 257/412 [62%] eyes, p < 0.001). Confidence was significantly higher with Dixon-T2WI than with the conventional set (2.35 versus 2.24, p = 0.003). CONCLUSION: Dixon-T2WI showed higher sensitivity and specificity and showed fewer artifacts than a conventional protocol when assessing thyroid eye disease, in addition to higher self-reported confidence. KEY POINTS: ⢠Dixon-T2WI has better sensitivity and specificity than a conventional protocol for assessing inflamed extraocular muscles in patients with thyroid eye disease. ⢠Dixon-T2WI shows significantly fewer artifacts than fat-suppressed T2WI. ⢠Dixon-T2WI is faster and is associated with significantly higher self-reported reader confidence as compared to a conventional protocol when assessing inflammatory extraocular muscles.
Asunto(s)
Oftalmopatía de Graves , Imagen por Resonancia Magnética , Adulto , Anciano , Artefactos , Femenino , Oftalmopatía de Graves/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
The vast majority of current microfluidic devices are produced using soft lithography, a technique with strong limitations regarding the fabrication of three-dimensional architectures. Additive manufacturing holds great promises to overcome these limitations, but conventional machines still lack the resolution required by most microfluidic applications. 3D printing machines based on two-photon lasers, in contrast, have the needed resolution but are too limited in speed and size of the global device. Here we demonstrate how the resolution of conventional stereolithographic machines can be improved by a direct programming of the laser path and can contribute to bridge the gap between the two above technologies, allowing the direct printing of features between 10 and 100 µm, corresponding to a large fraction of microfluidic applications. This strategy allows to achieve resolutions limited only by the physical size of the laser beam, decreasing by a factor at least 2× the size of the smallest features printable, and increasing their reproducibility by a factor 5. The approach was applied to produce an open microfluidic device with the reversible seal, integrating periodical patterns using the simple motifs, and validated by the fabrication of a deterministic lateral displacement particles sorting device. The sorting of polystyrene beads (diameter: 20 µm and 45 µm) was achieved with a specificity >95%, comparable with that achieved with arrays prepared by microlithography.