超声对先天性肌性斜颈伴发育性髋关节异常的诊断价值

Diagnostic value of ultrasonography for developmental dysplasia of the hip in infants with congenital muscular torticollis

目的 :探讨超声对先天性肌性斜颈(CMT)伴发育性髋关节异常(DDH)的诊断价值。方法 :回顾性分析176例CMT患儿超声检查时双侧胸锁乳突肌(SCM)厚度、髋关节Graf分型及临床相关资料,将其分为CMT+DDH组和CMT组进行对照分析。结果:CMT+DDH占11.4%(20/176);2组性别比、两者发病方向差异均无统计学意义(均P>0.05);CMT+DDH组双侧SCM厚度差值和双侧SCM厚度比率均明显高于CMT组(均P<0.05);分别以双侧SCM厚度差值≥0.74 cm和双侧SCM厚度比率≥0.24为临界值,预测DDH的敏感度分别为50.0%和45.0%,特异度分别为77.6%和83.3%。结论:CMT和DDH有一定共存比例,超声显示双侧SCM厚度差值和厚度比率对CMT伴DDH具有预测价值,是早期诊断CMT与DDH的重要依据。

Objective：To investigate the diagnostic value of ultrasonography（US） for developmental dysplasia of the hip（DDH）in infants with congenital muscular torticollis（CMT）. Methods：Cases of 176 infants less than six months old diagnosed as CMT were recruited retrospectively. We reviewed the sternocleidomastoid muscle（SCM） thickness and Graf＇s classification of hips based on US. The results were divided into two groups：CMT with DDH group and CMT group. The ultrasonic and clinical data were analyzed. Results：Twenty（11.4%） patients out of 176 CMT infants were diagnosed as having DDH by US. There was no significant difference between male and female,and between left and right side in two diseases. The difference and ratio of the SCM thickness between the normal and abnormal side in CMT with DDH group were significantly greater than those in CMT group（P=0.035,0.038）. Receiver operating characteristic analysis showed when considering the SCM difference ≥0.74 cm and the SCM ratio ≥0.24 as cut-off value to predict DDH,the sensitivity were 50.0% and 45.0%,and the specificity were 77.6% and83.3%,respectively. Conclusions：There is a certain coexistence of CMT and DDH in infants. The SCM ratio or difference of US has predictive value for DDH with CMT and it is a very effective and feasible measure for early diagnosis of CMT and DDH.