Davide Caramella MD, Presenter: Nothing to Disclose

Salvatore Mazzeo, Abstract Co-Author: Nothing to Disclose

Pia Torri, Abstract Co-Author: Nothing to Disclose

Luca Salvatori, Abstract Co-Author: Nothing to Disclose

Stefano Sellari Franceschini, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

To evaluate with multislice CT the outcome of surgical treatment in patients affected by Graves’ ophthalmopathy, by comparing pre-operative and post-operative CT findings.

Nine patients affected by severe Graves’ ophthalmopathy were studied with multislice CT before and 3 months after bilateral surgical decompression. All patients had been previously submitted to corticosteroid therapy (5 cases) or to steroid therapy associated with radiotherapy (4 cases). The clinical indications to surgery were: severe proptosis (8 cases) and/or diplopia (4 cases) and/or compressive optic neuropathy (1 case).The following CT findings were evaluated: proptosis, extrinsic muscles, optical nerve, orbital fat tissue, paranasal sinuses. The post-operative CT examination allowed morphological analysis of the surgical bony breaches and measurement of the volume of the removed bone. For this evaluation the pre-operative and post-operative CT datasets were transferred to a dedicated workstation (Dextroscope; Volume Interactions) to obtain a three-dimensional representation of the orbital bony walls, and to measure the volume of the removed bone.

In 2 cases a reduction in diplopia was obtained, while in 1 cases diplopia occurred after surgery. In the patient with compressive optic neuropathy, the symptoms persisted. In 7 patients, an inflammatory involvement of the paranasal sinuses was observed.In the post-operative CT the reduction of proptosis resulted bilateral in 7 cases, monolateral in 1 case. No variation of proptosis was observed in 1 case. The 3D reformations allowed to evaluate the morphology and the symmetry of the bony breaches. The volume of the removed bone ranged between 8 cc and 37 cc; this parameter correlated with the reduction of the proptosis (p < 0.1), but no correlation with the diplopia was found.

Multislice CT allows an accurate evaluation of patients affected by Graves’ ophthalmopathy submitted to surgical decompression and permits the assessment of surgical results, by means of precise measurements of proptosis and of the extent of the orbital bony breaches.

Caramella, D, Mazzeo, S, Torri, P, Salvatori, L, Sellari Franceschini, S, Bartolozzi, C, Multislice CT Evaluation of Patients with Graves’ Ophthalmopathy Submitted to Surgical Decompression.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415401.html