幼儿颈部肌性损伤的超声表现

Ultrasound Manifestations of Cervical Muscular Injury in Young Children

目的 通过超声观察对 1 0 9例不同年龄的幼儿颈部的胸锁乳突肌肌性损伤性肿块进行分类分析 ,以提供合适的治疗建议。方法 利用高频探头和彩色多普勒超声技术 ,观察、记录不同时期肿块的不同声像图特征 ,血供情况 ,与治疗结果相对照。结果 超声显示病程越短 ,该肌腱的上下径长度与健侧越接近 ,血流越丰富 ,阻力指数 (RI)≤ 6。中期以后 ,病变侧胸锁乳突肌上下径长度较健侧逐步缩短 ,内部回声增强 ,与正常肌群界限逐渐清晰 ,血流信号逐步减少 ,阻力指数增高 ,RI≥ 0 .7。晚期演变成增强回声的实质不均质光团 ,结构紊乱 ,与正常肌群界限清晰 ,局部血流信号基本消失 ,偶而呈星点状闪烁。早期的 6 / 6 7例 ,未经治疗自愈 ,5 4 / 6 7例经推拿治疗痊愈 ,其余未经推拿治疗或治疗不正规 ,保守治疗失败。中期的 9/ 36例经过推拿治疗痊愈 ,其余的 2 7/ 36例和晚期的 6例均经手术松解治疗。结论 超声检查对于获得软组织信息是一个较安全、准确、便捷的方法 ,彩色多普勒检查可帮助区分不同阶段病变的肿块 。

Objective Cervical masses of 109 cases caused by musculi sternocleidomastoideus injury were classified with ultrasound examination to provide appropriate therapeutic advice. Methods Various ultrasound image characteristics,blood supply of the masses in various stages were recorded with high frequency probe and color Doppler and were compared before and after therapy. Results Ultrasound examination showed that the earlier the clinical course,the closer the upper and the lower diameter to that of the healthy side and the richer the blood supply.The resistant index(RI)was≤6.After the middle stage,higher and lower diameter of the injury side of musculi sternocleidomastoideus shortened gradually with increase of inner echo strength and clear boundary with normal muscle,the echo signal was decreased gradually and the resistant index was increased,RI≥0 7.In those of advanced patients,there were inhomogeneous light masses with disordered structure and clear boundary with the normal muscle and local blood flow signal disappeared generally with occasionally spotted star like twinkles.Six cases(6/67)of early stage were cured spontaneously without therapy,Fifty four cases(54/67) were cured by massage and the other patients with irregular therapy or without massage had no effect after conservative therapy;nine cases(9/36) of medium stage were cured after massage,the remaining 27 cases(27/36) and 6 advanced cases were treated with surgery. Conclusions Ultrasound examination is a safe,accurate and simpe method for obtaining soft tissue signals.Color Doppler examination can help for distinguishing mass lesvons of various stages to provide basis for clinical therapy.