Quantitative MRI of the extra-ocular muscles might have diagnostic value and play a role in therapeutic monitoring in myasthenia gravis (MG). Our data show a slight increase in volume, fat fraction and T2water in extra-ocular muscles of MG patients compared to controls. Volume and fat fraction changes were most pronounced in chronic MG patients, T2water changes were most pronounced in recently diagnosed and untreated MG patients. The absence of gross structural changes implies that eye muscle weakness might be reversible, even in chronic patients with residual ophthalmoplegia.
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