先天性斜颈超声与病理的比较研究

Congenital Muscular Torticollis:A Correlative Study of Ultrasonography and Pathology

目的:婴幼儿胸锁乳突肌假性肿瘤和先天性斜颈的超声表现较复杂,而且随年龄变化。为了探讨超声与临床变化的病理基础,本研究进行回声强度、病理特点与临床表现的比较研究。方法:32例患儿,其中14例有肿块,18例无肿块,检测两侧胸锁乳突肌回声、前后径及左右径,切除病变组织行光镜和电镜检查。结果:电镜发现增生的间质中有肌母细胞存在,这可能是该病超声及临床多种转归的原因。结论:揭示肌纤维化是引起回声变化的主要原因。相关分析显示病侧肌组织厚度(F=-0.86、P<0.05)、年龄(F=2.86、P<0.05)和纤维组织的比例(F=1.86、P<0.05)明显影响回声强度。阐明超声是本病诊断、随访有用工具。

Objective:The ultrasonographic findings of congenital muscular torticollis(CMT) and sternocleidomastoid pseudotumor of infants(SCMPOI)are multiform and vary with the dura- tion.The comparative study of the clinical manifestations,pathology and echo intensities may give some information about the ultrasonographical and clinical changes of the disease.Methods:Con- sequently,in the ultrasonic findings of 32 children(14 with SCMPOI and 18 without),the thick- ness of bilateral sternocleidomastoid muscles were measured and compared with the pathological and clinical manifastations.The corresponding muscle biopsy samples were studied by electronic and light microscope.Results:Fibrosis was the main cause of increase of muscle echogenicity. The correlative analysis showed that the thickness of the involved muscle(F=1.86,P<0.05), age(F=2.86,P<0.05))and percentage of fibrous tissue(F=1.86,P<0.05)signigicantly influ- enced on the echo intensity.Myoblasts of various differentiation and maturation in the hyperplastic interstitial tissue of the tumor may explain the various clinical turns.Conclusions:The ultrasono- graphy is a useful tool for the diagnosis and follow-up of the disease.