超声在不同时期先天性肌性斜颈患儿中的诊断价值

Value of ultrasonography in diagnosis of children with congenital muscular torticollis in different stages

目的探讨超声对不同时期先天性肌性斜颈(CMT)患儿的诊断价值。方法回顾性分析50例经临床或手术证实为CMT患儿的声像图特点,包括病变区域边界、胸锁乳突肌(SCM)厚度、回声强度及彩色多普勒血流表现,比较﹤1岁患儿和≥1岁患儿超声表现的差异性。结果 50例患儿中,超声诊断CMT患儿46例,诊断准确率92.0%。28例﹤1岁患儿超声表现为患侧SCM局限性增厚,彩色多普勒血流成像(CDFI)示部分病变内部或周边点线状血流信号;18例≥1岁患儿超声表现为患侧SCM厚度多变薄,肌层回声可弥漫性增强或肌层内出现条带状强回声,CDFI未见明显血流信号。两组患儿受累SCM的超声特征比较差异有统计学意义(P﹤0.05)。结论不同时期CMT患儿的二维及彩色多普勒超声表现具有特异性,可指导临床医师选择合适的治疗方式。

Objective To explore the value of ultrasonography in diagnosis of children with congenital muscular torti- collis（CMT） in different stages. Methods The sonographic features of 50 patients with CMT proved by the clinical diagnosis and operation were analyzed retrospectively, including the boundary,sternocleidomastoid muscle （SCM） thickness , echo intensity and color Doppler flow imaging of the lesion. The sonographic features of CMT between the children 〈 1 year old （n=28） and ≥ 1 year old （n= 18） were compared. Results Forty-six cases of 50 patients were diagnosed as CMT by ultrasonography, the diagnostic ac- curacy rate was 92.0%. There were significant differences between the children 〈 1 year old and ≥ 1 year old （P 〈 0.05）. The ul- trasonographie appearances of the children 〈 I year old included local thickening of SCM and point or linear blood flow signals in- side or around the lesions, while those of the children ≥ 1 year old included thinning of the affected SCM, diffusely increased echo signals,or cord-like hyperechoic signals inside the muscle layer and no significant blood flow signals. Conclusion Children with CMT in different stages had different sonographic features, which could improve the diagnostic accuracy rate of CMT by ultra- sonography and guide the clinical treatment choice.