Research progress and clinical utility of multi-parameter orbital MRI in thyroid-associated ophthalmopathy

Thyroid-associated ophthalmopathy (TAO), the most common orbital disease in adults, is a specific autoimmune condition closely associated with thyroid dysfunction, primarily affecting orbital fat and extraocular muscles. Multiparametric magnetic resonance imaging (MRI) holds unique value in diagnosing TAO, staging disease activity and progression evaluation by providing multidimensional information on tissue morphology, edema, fat infiltration, and fibrosis. This review examines conventional and advanced MRI techniques-such as T1WI, T2WI, diffusion-weighted imaging, dynamic contrast-enhanced MRI and magnetization transfer imaging-for their research progress and clinical utility. Recent advances in artificial intelligence (AI) applications for orbital MRI in TAO are also discussed. AI-enhanced multiparametric orbital MRI facilitates the comprehensive evaluation of TAO, covering image acquisition, quantification of metrics, and the establishment of predictive assessment models. Despite these advancements, challenges persist, such as the need to standardize quantitative parameters, validate findings through larger multicenter studies, and develop more efficient scanning protocols. Future research should prioritize parameter standardization, automated analysis workflows, and integration of multiparametric data to advance personalized TAO management.