Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study (463 views) (PDF restricted 252 views)
Neuroradiol J (ISSN: 1971-4009, 1971-4009print, 1971-4009linking), 2013 Aug; 26(4): 373-379.
Export to BibTeX Export to EndNote
Paper type: Journal Article, Clinical Trial, Validation Studies,
Impact factor: 2.16, 5-year impact factor: 2.304
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-84884711917&partnerID=40&md5=61e04db53b2edda52d151d2887c8bf4f
Keywords: Graves, Orbitopathy, Mri Segmentation, Orbital Quadrant Definition, Regional Orbital Fat Quantification, Semiautomatic Numeric Segmentation, Validation, Adipose Tissue, Adult, Article, Clinical Article, Controlled Study, Endocrine Ophthalmopathy, Female, Graves Disease, Human, Measurement, Nuclear Magnetic Resonance Imaging, Validation Study, Exophthalmos, Graves Ophthalmopathy, Middle Aged, Reproducibility Of Results, Adipose Tissue Pathology, Exophthalmos Pathology, Graves Ophthalmopathy Pathology, Magnetic Resonance Imaging Methods Standards, Orbit Pathology,
Affiliations:
*** IBB - CNR ***
Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
Department of Advanced Biomedical Sciences, Neuroradiology, Federico II University, Naples, Italy
Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
Naples, Italy - marco. comerci@ibb. cnr. it.
Consiglio Nazionale delle Ricerche
Universita degli Studi di Napoli Federico II
References:
Tian, S., Nishida, Y., Isberg, B., Lennerstrand, G., MRI measurements of normal extraocular muscles and other orbital structures (2000) Graefe's Archive for Clinical and Experimental Ophthalmology, 238 (5), pp. 393-404. , DOI 10. 1007/s00417005037
Feldon, S. E., Celina, P., Saundra, K., Quantitive computer tomography of Graves' ophthalmopathy (1985) Arch Ophtal, 103, pp. 213-215
Peyster, R. G., Ginsberg, F., Silber, J. H., Adler, L. P., Exophthalmos caused by excessive fat: CT volumetric analysis and differential diagnosis (1986) American Journal of Roentgenology, 146 (3), pp. 459-464
Nishida, Y., Aoki, Y., Hayashi, O., Murata, T., Nishida, E., Kani, K., Volume measurement of horizontal extraocular muscles with magnetic resonance imaging (1996) Japanese Journal of Ophthalmology, 40 (3), pp. 439-446
Majos, A., Grzelak, P., Mynarczyk, W., Assessment of the volume of intra-orbital structures using the numerical segmentation image technique (NSI): The extra ocular muscles (2007) Endokrynol Pol., 58 (2), pp. 110-115
Bartalena, L., Pinchera, A., Marcocci, C., Management of graves' ophthalmopathy: Reality and perspectives (2000) Endocrine Reviews, 21 (2), pp. 168-199. , DOI 10. 1210/er. 21. 2. 168
Weetman, A. P., Cohen, S., Gatter, K. C., Fells, P., Shine, B., Immunohistochemical analysis of the retrobulbar tissues in Graves' ophthalmopathy (1989) Clinical and Experimental Immunology, 75 (2), pp. 222-227
Grubeck-Loebenstein, B., Trieb, K., Sztankay, A., Holter, W., Anderl, H., Wick, G., Retrobulbar T cells from patients with Graves' ophthalmopathy are CD8+ and specifically recognize autologous fibroblasts (1994) Journal of Clinical Investigation, 93 (6), pp. 2738-2743
Heufelder, A., Herterich, S., Ernst, G., Analysis of retro orbital T cell antigen receptor variable region gene usage in patients with Graves' ophthalmopathy (1995) Eur J Endocrinol., 132, pp. 266-277
Bartley, G. B., Fatourechi, V., Kadrmas, E. F., Jacobsen, S. J., Ilstrup, D. M., Garrity, J. A., Gorman, C. A., Clinical features of Graves' ophthalmopathy in an incidence cohort (1996) American Journal of Ophthalmology, 121 (3), pp. 284-290
Feldon, S. E., Lee, C. P., Muramatsu, S. K., Weiner, J. M., Quantitative computed tomography of Graves' ophthalmopathy. Extraocular muscle and orbital fat in development of optic neuropathy (1985) Archives of Ophthalmology, 103 (2), pp. 213-215
Boboridis, K. G., Gogakos, A., Krassas, G. E., Orbital fat decompression for Graves' orbitopathy: A literature review (2010) Pediatr Endocrinol Rev, 7 (SUPPL. 2), pp. 222-226
Alfano, B., Comerci, M., Larobina, M., An MRI digital brain phantom for validation of segmentation methods (2011) Med Image Anal, 15 (3), pp. 329-339
Alfano, B., Brunetti, A., Covelli, E. M., Quarantelli, M., Panico, M. R., Ciarmiello, A., Salvatore, M., Unsupervised, automated segmentation of the normal brain using a multispectral relaxometric magnetic resonance approach (1997) Magnetic Resonance in Medicine, 37 (1), pp. 84-93. , DOI 10. 1002/mrm. 1910370113
Nishida, Y., Tian, S., Isberg, B., Tallstedt, L., Lennerstrand, G., Significance of orbital fatty tissue for exophthalmos in thyroid-associated ophthalmopathy (2002) Graefe's Archive for Clinical and Experimental Ophthalmology, 240 (7), pp. 515-520
Prummel, M. F., Gerding, M. N., Zonneveld, F. W., Wiersinga, W. M., The usefulness of quantitative orbital magnetic resonance imaging in Graves' ophthalmopathy (2001) Clinical Endocrinology, 54 (2), pp. 205-209. , DOI 10. 1046/j. 1365-2265. 2001. 01220. x
Dolman, P. J., Cahill, K., Czyz, C. N., Reliability of estimating ductions in thyroid eye disease: An International Thyroid Eye Disease Society multicenter study (2012) Ophthalmology, 119 (2), pp. 382-389
Ossoinig, K. C., The role of standardized ophthalmic echography in the management of Graves' ophthalmopathy (1989) Dev Ophthalmol, 20, pp. 28-37
Feldon, S. E., Weiner, J. M., Clinical significance of extraocular muscle volumes in Graves' ophthalmopathy. A quantitative computed tomography study (1982) Archives of Ophthalmology, 100 (8), pp. 1266-1269
Matsuo, H., Motomura, M., Takeo, G., Magnetic resonance imaging in diagnosis and follow-up of minimal thyroid ophthalmopathy (1991) Jpn J Med, 30 (3), pp. 229-232
Bahn, R. S., Clinical review 157 - Pathophysiology of Graves' ophthalmopathy: The cycle of disease (2003) Journal of Clinical Endocrinology and Metabolism, 88 (5), pp. 1939-1946. , DOI 10. 1210/jc. 2002-030010
Ben, S. G. J., Schwarcz, R. M., Mansury, A. M., Wang, L., McCann, J. D., Goldberg, R. A., Minimally invasive orbital decompression: Local anesthesia and hand-carved bone (2005) Archives of Ophthalmology, 123 (12), pp. 1671-1675. , http: //archopht. ama-assn. org/cgi/reprint/123/12/1671, DOI 10. 1001/archopht. 123. 12. 1671
Chang, M., Baek, S., Lee, T. S., Long-term outcomes of unilateral orbital fat decompression for thyroid eye disease (2013) Graefes Arch Clin Exp Ophthalmol, 251 (3), pp. 935-939
Strianese, D., Piscopo, R., Elefante, A., Unilateral proptosis in thyroid eye disease with subsequent contralateral involvement: Retrospective follow-up study (2013) BMC Ophthalmol, 30, pp. 13-21
Feldon, S.E., Celina, P., Saundra, K., Quantitive computer tomography of Graves' ophthalmopathy (1985) Arch Ophtal, 103, pp. 213-215
Peyster, R.G., Ginsberg, F., Silber, J.H., Adler, L.P., Exophthalmos caused by excessive fat: CT volumetric analysis and differential diagnosis (1986) American Journal of Roentgenology, 146 (3), pp. 459-464
Weetman, A.P., Cohen, S., Gatter, K.C., Fells, P., Shine, B., Immunohistochemical analysis of the retrobulbar tissues in Graves' ophthalmopathy (1989) Clinical and Experimental Immunology, 75 (2), pp. 222-227
Bartley, G.B., Fatourechi, V., Kadrmas, E.F., Jacobsen, S.J., Ilstrup, D.M., Garrity, J.A., Gorman, C.A., Clinical features of Graves' ophthalmopathy in an incidence cohort (1996) American Journal of Ophthalmology, 121 (3), pp. 284-290
Feldon, S.E., Lee, C.P., Muramatsu, S.K., Weiner, J.M., Quantitative computed tomography of Graves' ophthalmopathy. Extraocular muscle and orbital fat in development of optic neuropathy (1985) Archives of Ophthalmology, 103 (2), pp. 213-215
Boboridis, K.G., Gogakos, A., Krassas, G.E., Orbital fat decompression for Graves' orbitopathy: A literature review (2010) Pediatr Endocrinol Rev, 7 (SUPPL. 2), pp. 222-226
Prummel, M.F., Gerding, M.N., Zonneveld, F.W., Wiersinga, W.M., The usefulness of quantitative orbital magnetic resonance imaging in Graves' ophthalmopathy (2001) Clinical Endocrinology, 54 (2), pp. 205-209. , DOI 10.1046/j.1365-2265.2001.01220.x
Dolman, P.J., Cahill, K., Czyz, C.N., Reliability of estimating ductions in thyroid eye disease: An International Thyroid Eye Disease Society multicenter study (2012) Ophthalmology, 119 (2), pp. 382-389
Ossoinig, K.C., The role of standardized ophthalmic echography in the management of Graves' ophthalmopathy (1989) Dev Ophthalmol, 20, pp. 28-37
Feldon, S.E., Weiner, J.M., Clinical significance of extraocular muscle volumes in Graves' ophthalmopathy. A quantitative computed tomography study (1982) Archives of Ophthalmology, 100 (8), pp. 1266-1269
Bahn, R.S., Clinical review 157 - Pathophysiology of Graves' ophthalmopathy: The cycle of disease (2003) Journal of Clinical Endocrinology and Metabolism, 88 (5), pp. 1939-1946. , DOI 10.1210/jc.2002-030010
Ben, S.G.J., Schwarcz, R.M., Mansury, A.M., Wang, L., McCann, J.D., Goldberg, R.A., Minimally invasive orbital decompression: Local anesthesia and hand-carved bone (2005) Archives of Ophthalmology, 123 (12), pp. 1671-1675. , http://archopht.ama-assn.org/cgi/reprint/123/12/1671, DOI 10.1001/archopht.123.12.1671
Neuroradiol J (ISSN: 1971-4009, 1971-4009print, 1971-4009linking), 2013 Aug; 26(4): 373-379.
Export to BibTeX Export to EndNote
Paper type: Journal Article, Clinical Trial, Validation Studies,
Impact factor: 2.16, 5-year impact factor: 2.304
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-84884711917&partnerID=40&md5=61e04db53b2edda52d151d2887c8bf4f
Keywords: Graves, Orbitopathy, Mri Segmentation, Orbital Quadrant Definition, Regional Orbital Fat Quantification, Semiautomatic Numeric Segmentation, Validation, Adipose Tissue, Adult, Article, Clinical Article, Controlled Study, Endocrine Ophthalmopathy, Female, Graves Disease, Human, Measurement, Nuclear Magnetic Resonance Imaging, Validation Study, Exophthalmos, Graves Ophthalmopathy, Middle Aged, Reproducibility Of Results, Adipose Tissue Pathology, Exophthalmos Pathology, Graves Ophthalmopathy Pathology, Magnetic Resonance Imaging Methods Standards, Orbit Pathology,
Affiliations:
*** IBB - CNR ***
Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
Department of Advanced Biomedical Sciences, Neuroradiology, Federico II University, Naples, Italy
Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
Naples, Italy - marco. comerci@ibb. cnr. it.
Consiglio Nazionale delle Ricerche
Universita degli Studi di Napoli Federico II
References:
Tian, S., Nishida, Y., Isberg, B., Lennerstrand, G., MRI measurements of normal extraocular muscles and other orbital structures (2000) Graefe's Archive for Clinical and Experimental Ophthalmology, 238 (5), pp. 393-404. , DOI 10. 1007/s00417005037
Feldon, S. E., Celina, P., Saundra, K., Quantitive computer tomography of Graves' ophthalmopathy (1985) Arch Ophtal, 103, pp. 213-215
Peyster, R. G., Ginsberg, F., Silber, J. H., Adler, L. P., Exophthalmos caused by excessive fat: CT volumetric analysis and differential diagnosis (1986) American Journal of Roentgenology, 146 (3), pp. 459-464
Nishida, Y., Aoki, Y., Hayashi, O., Murata, T., Nishida, E., Kani, K., Volume measurement of horizontal extraocular muscles with magnetic resonance imaging (1996) Japanese Journal of Ophthalmology, 40 (3), pp. 439-446
Majos, A., Grzelak, P., Mynarczyk, W., Assessment of the volume of intra-orbital structures using the numerical segmentation image technique (NSI): The extra ocular muscles (2007) Endokrynol Pol., 58 (2), pp. 110-115
Bartalena, L., Pinchera, A., Marcocci, C., Management of graves' ophthalmopathy: Reality and perspectives (2000) Endocrine Reviews, 21 (2), pp. 168-199. , DOI 10. 1210/er. 21. 2. 168
Weetman, A. P., Cohen, S., Gatter, K. C., Fells, P., Shine, B., Immunohistochemical analysis of the retrobulbar tissues in Graves' ophthalmopathy (1989) Clinical and Experimental Immunology, 75 (2), pp. 222-227
Grubeck-Loebenstein, B., Trieb, K., Sztankay, A., Holter, W., Anderl, H., Wick, G., Retrobulbar T cells from patients with Graves' ophthalmopathy are CD8+ and specifically recognize autologous fibroblasts (1994) Journal of Clinical Investigation, 93 (6), pp. 2738-2743
Heufelder, A., Herterich, S., Ernst, G., Analysis of retro orbital T cell antigen receptor variable region gene usage in patients with Graves' ophthalmopathy (1995) Eur J Endocrinol., 132, pp. 266-277
Bartley, G. B., Fatourechi, V., Kadrmas, E. F., Jacobsen, S. J., Ilstrup, D. M., Garrity, J. A., Gorman, C. A., Clinical features of Graves' ophthalmopathy in an incidence cohort (1996) American Journal of Ophthalmology, 121 (3), pp. 284-290
Feldon, S. E., Lee, C. P., Muramatsu, S. K., Weiner, J. M., Quantitative computed tomography of Graves' ophthalmopathy. Extraocular muscle and orbital fat in development of optic neuropathy (1985) Archives of Ophthalmology, 103 (2), pp. 213-215
Boboridis, K. G., Gogakos, A., Krassas, G. E., Orbital fat decompression for Graves' orbitopathy: A literature review (2010) Pediatr Endocrinol Rev, 7 (SUPPL. 2), pp. 222-226
Alfano, B., Comerci, M., Larobina, M., An MRI digital brain phantom for validation of segmentation methods (2011) Med Image Anal, 15 (3), pp. 329-339
Alfano, B., Brunetti, A., Covelli, E. M., Quarantelli, M., Panico, M. R., Ciarmiello, A., Salvatore, M., Unsupervised, automated segmentation of the normal brain using a multispectral relaxometric magnetic resonance approach (1997) Magnetic Resonance in Medicine, 37 (1), pp. 84-93. , DOI 10. 1002/mrm. 1910370113
Nishida, Y., Tian, S., Isberg, B., Tallstedt, L., Lennerstrand, G., Significance of orbital fatty tissue for exophthalmos in thyroid-associated ophthalmopathy (2002) Graefe's Archive for Clinical and Experimental Ophthalmology, 240 (7), pp. 515-520
Prummel, M. F., Gerding, M. N., Zonneveld, F. W., Wiersinga, W. M., The usefulness of quantitative orbital magnetic resonance imaging in Graves' ophthalmopathy (2001) Clinical Endocrinology, 54 (2), pp. 205-209. , DOI 10. 1046/j. 1365-2265. 2001. 01220. x
Dolman, P. J., Cahill, K., Czyz, C. N., Reliability of estimating ductions in thyroid eye disease: An International Thyroid Eye Disease Society multicenter study (2012) Ophthalmology, 119 (2), pp. 382-389
Ossoinig, K. C., The role of standardized ophthalmic echography in the management of Graves' ophthalmopathy (1989) Dev Ophthalmol, 20, pp. 28-37
Feldon, S. E., Weiner, J. M., Clinical significance of extraocular muscle volumes in Graves' ophthalmopathy. A quantitative computed tomography study (1982) Archives of Ophthalmology, 100 (8), pp. 1266-1269
Matsuo, H., Motomura, M., Takeo, G., Magnetic resonance imaging in diagnosis and follow-up of minimal thyroid ophthalmopathy (1991) Jpn J Med, 30 (3), pp. 229-232
Bahn, R. S., Clinical review 157 - Pathophysiology of Graves' ophthalmopathy: The cycle of disease (2003) Journal of Clinical Endocrinology and Metabolism, 88 (5), pp. 1939-1946. , DOI 10. 1210/jc. 2002-030010
Ben, S. G. J., Schwarcz, R. M., Mansury, A. M., Wang, L., McCann, J. D., Goldberg, R. A., Minimally invasive orbital decompression: Local anesthesia and hand-carved bone (2005) Archives of Ophthalmology, 123 (12), pp. 1671-1675. , http: //archopht. ama-assn. org/cgi/reprint/123/12/1671, DOI 10. 1001/archopht. 123. 12. 1671
Chang, M., Baek, S., Lee, T. S., Long-term outcomes of unilateral orbital fat decompression for thyroid eye disease (2013) Graefes Arch Clin Exp Ophthalmol, 251 (3), pp. 935-939
Strianese, D., Piscopo, R., Elefante, A., Unilateral proptosis in thyroid eye disease with subsequent contralateral involvement: Retrospective follow-up study (2013) BMC Ophthalmol, 30, pp. 13-21
Feldon, S.E., Celina, P., Saundra, K., Quantitive computer tomography of Graves' ophthalmopathy (1985) Arch Ophtal, 103, pp. 213-215
Peyster, R.G., Ginsberg, F., Silber, J.H., Adler, L.P., Exophthalmos caused by excessive fat: CT volumetric analysis and differential diagnosis (1986) American Journal of Roentgenology, 146 (3), pp. 459-464
Weetman, A.P., Cohen, S., Gatter, K.C., Fells, P., Shine, B., Immunohistochemical analysis of the retrobulbar tissues in Graves' ophthalmopathy (1989) Clinical and Experimental Immunology, 75 (2), pp. 222-227
Bartley, G.B., Fatourechi, V., Kadrmas, E.F., Jacobsen, S.J., Ilstrup, D.M., Garrity, J.A., Gorman, C.A., Clinical features of Graves' ophthalmopathy in an incidence cohort (1996) American Journal of Ophthalmology, 121 (3), pp. 284-290
Feldon, S.E., Lee, C.P., Muramatsu, S.K., Weiner, J.M., Quantitative computed tomography of Graves' ophthalmopathy. Extraocular muscle and orbital fat in development of optic neuropathy (1985) Archives of Ophthalmology, 103 (2), pp. 213-215
Boboridis, K.G., Gogakos, A., Krassas, G.E., Orbital fat decompression for Graves' orbitopathy: A literature review (2010) Pediatr Endocrinol Rev, 7 (SUPPL. 2), pp. 222-226
Prummel, M.F., Gerding, M.N., Zonneveld, F.W., Wiersinga, W.M., The usefulness of quantitative orbital magnetic resonance imaging in Graves' ophthalmopathy (2001) Clinical Endocrinology, 54 (2), pp. 205-209. , DOI 10.1046/j.1365-2265.2001.01220.x
Dolman, P.J., Cahill, K., Czyz, C.N., Reliability of estimating ductions in thyroid eye disease: An International Thyroid Eye Disease Society multicenter study (2012) Ophthalmology, 119 (2), pp. 382-389
Ossoinig, K.C., The role of standardized ophthalmic echography in the management of Graves' ophthalmopathy (1989) Dev Ophthalmol, 20, pp. 28-37
Feldon, S.E., Weiner, J.M., Clinical significance of extraocular muscle volumes in Graves' ophthalmopathy. A quantitative computed tomography study (1982) Archives of Ophthalmology, 100 (8), pp. 1266-1269
Bahn, R.S., Clinical review 157 - Pathophysiology of Graves' ophthalmopathy: The cycle of disease (2003) Journal of Clinical Endocrinology and Metabolism, 88 (5), pp. 1939-1946. , DOI 10.1210/jc.2002-030010
Ben, S.G.J., Schwarcz, R.M., Mansury, A.M., Wang, L., McCann, J.D., Goldberg, R.A., Minimally invasive orbital decompression: Local anesthesia and hand-carved bone (2005) Archives of Ophthalmology, 123 (12), pp. 1671-1675. , http://archopht.ama-assn.org/cgi/reprint/123/12/1671, DOI 10.1001/archopht.123.12.1671
Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study
This study was designed to validate a novel semi-automated segmentation method to measure regional intra-orbital fat tissue volume in Graves' ophthalmopathy. Twenty-four orbits from 12 patients with Graves' ophthalmopathy, 24 orbits from 12 controls, ten orbits from five MRI study simulations and two orbits from a digital model were used. Following manual region of interest definition of the orbital volumes performed by two operators with different levels of expertise, an automated procedure calculated intra-orbital fat tissue volumes (global and regional, with automated definition of four quadrants). In patients with Graves' disease, clinical activity score and degree of exophthalmos were measured and correlated with intra-orbital fat volumes. Operator performance was evaluated and statistical analysis of the measurements was performed. Accurate intra-orbital fat volume measurements were obtained with coefficients of variation below 5\\%. The mean operator difference in total fat volume measurements was 0.56\\%. Patients had significantly higher intra-orbital fat volumes than controls (p<0.001 using Student's t test). Fat volumes and clinical score were significantly correlated (p<0.001). The semi-automated method described here can provide accurate, reproducible intra-orbital fat measurements with low inter-operator variation and good correlation with clinical data.
This study was designed to validate a novel semi-automated segmentation method to measure regional intra-orbital fat tissue volume in Graves' ophthalmopathy. Twenty-four orbits from 12 patients with Graves' ophthalmopathy, 24 orbits from 12 controls, ten orbits from five MRI study simulations and two orbits from a digital model were used. Following manual region of interest definition of the orbital volumes performed by two operators with different levels of expertise, an automated procedure calculated intra-orbital fat tissue volumes (global and regional, with automated definition of four quadrants). In patients with Graves' disease, clinical activity score and degree of exophthalmos were measured and correlated with intra-orbital fat volumes. Operator performance was evaluated and statistical analysis of the measurements was performed. Accurate intra-orbital fat volume measurements were obtained with coefficients of variation below 5\\%. The mean operator difference in total fat volume measurements was 0.56\\%. Patients had significantly higher intra-orbital fat volumes than controls (p<0.001 using Student's t test). Fat volumes and clinical score were significantly correlated (p<0.001). The semi-automated method described here can provide accurate, reproducible intra-orbital fat measurements with low inter-operator variation and good correlation with clinical data.
Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study
| ▼ Relaxometry based MRI limb segmentation |
| ▼ Software development of digital MRI brain phantom |
Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study
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Le Moli R, Muscia V, Tumminia A, Frittitta L, Buscema M, Palermo F, Sciacca L, Squatrito S, Vigneri R
* Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy (871 views)
Nutrition (ISSN: 0939-4753, 1590-3729electronic), 2015; 25(5): 452-457.
Impact Factor: 3.39
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* Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy (871 views)
Nutrition (ISSN: 0939-4753, 1590-3729electronic), 2015; 25(5): 452-457.
Impact Factor: 3.39
View Export to BibTeX Export to EndNote
1 Records (1 excluding Abstracts).
Total impact factor: 3.39 (3.39 excluding Abstracts).
Total 5 year impact factor: 3.451 (3.451 excluding Abstracts).
Total impact factor: 3.39 (3.39 excluding Abstracts).
Total 5 year impact factor: 3.451 (3.451 excluding Abstracts).
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