方法：回顾性纳入2023年1月至2024年12月在攀枝花学院附属医院行^99mTc-DTPA SPECT/CT眼眶显像的TAO患者，根据临床活动性评分(CAS)标准，将TAO患者分为活动期组、非活动期组。由3名核医学科医师独立测量SUV_max、EOM并取平均值； 使用全自动电化学发光免疫分析仪检测TAO患者血清TRAb水平。采用非参数检验进行两组间的数据差异分析； 斯皮尔曼相关性分析CAS与SUV_max、EOM和TRAb的相关性； 以CAS为标准，绘制受试者工作特征(ROC)曲线评价SUV_max、EOM、TRAb的诊断效能以及三者的综合诊断效能； 采用组内相关系数(ICC)进行信度分析，评估SUV_max、EOM在3名测量者间的一致性。

结果：本研究纳入TAO患者99例198眼，其中男38例，女61例，年龄16-74(46.92±11.84)岁。活动期组46例92眼，年龄16-71(48.40±12.02)岁，男25例，女21例。非活动期组53例106眼，年龄17-74(45.46±11.59)岁，男13例，女40例。两组性别和年龄比较无差异(均P>0.05)，活动期组TAO患者的SUV_max、EOM和TRAb均高于非活动期组(均P<0.01)。相关性分析中，CAS与SUV_max、EOM和TRAb均呈正相关关系(r_s=0.734、0.622、0.404，均P<0.01)。以CAS为标准绘制ROC曲线，SUV_max、EOM、TRAb以及三者联合诊断的AUC分别为0.874、0.797、0.715、0.892。SUV_max、EOM的ICC值分别为0.925(95%CI：0.901-0.948，P<0.001)、0.943(95%CI：0.907-0.964，P<0.001)。

结论：在CAS这一主观评分之外，寻找客观影像学与血清学生物标志物的必要性，SUV_max和EOM测量为TAO活动性的评估提供了可视化和可量化的工具，同时联合TRAb能够提高其活动性评估的准确性。

METHODS: TAO patients underwent orbital ^99mTc-DTPA SPECT/CT imaging at the Affiliated Hospital of Panzhihua University between January 2023 and December 2024 were retrospectively enrolled. According to the clinical activity score(CAS), patients were classified into an active group and an inactive group. SUV_max and EOM were independently measured by three nuclear medicine physicians, and the mean values were used for analysis. Serum TRAb levels from TAO patients were measured using a fully automated electrochemiluminescence immunoassay analyzer. Nonparametric tests were used to compare differences between the two groups. Spearman correlation analysis was performed to assess the correlations of CAS with SUV_max, EOM, and TRAb. Using CAS as the reference standard, receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic performance of SUV_max, EOM, and TRAb, as well as their combination. Intraclass correlation coefficient(ICC)was used for reliability analysis to evaluate the consistency of SUV_max and EOM among the 3 measurers.

RESULTS: A total of 99 patients(198 eyes)with TAO were enrolled in this study, including 38 males and 61 females, aged 16-74(46.92±11.84)y. The active group comprised 46 patients(92 eyes), aged 16-71(48.40±12.02)y, with 25 males and 21 females. The inactive group included 53 patients(106 eyes), aged 17-74(45.46±11.59)y, consisting of 13 males and 40 females. There were no statistically significant differences between the two groups in terms of gender and age(P>0.05). Statistically significant differences were observed in SUV_max, EOM, and TRAb. Compared with the inactive group, the active group showed higher SUV_max, EOM, and TRAb levels(all P<0.01). Correlation analysis showed that CAS was positively correlated with SUV_max, EOM, and TRAb(r=0.734, 0.622, and 0.404, respectively, all P<0.01). ROC curves were plotted using CAS as the reference standard, and the AUCs for SUV_max, EOM, TRAb, and their combined diagnosis were 0.874, 0.797, 0.715, and 0.892, respectively. The ICC of SUV_max and EOM were 0.925(95%CI: 0.901-0.948, P<0.001)and 0.943(95%CI: 0.907-0.964, P<0.001)respectively.

CONCLUSION: Beyond CAS, there is a need to identify objective imaging and serological biomarkers. Measurements of SUV_max and EOM provide visualized and quantifiable tools for assessing TAO activity, and their combination with TRAb can further improve the accuracy of activity assessment.