剪切波弹性成像技术对低龄婴幼儿先天性肌斜颈的诊断价值

Diagnostic value of shear wave elastrography in younger infant with congenital muscular torticollis

目的应用实时剪切波弹性成像技术测量胸锁乳突肌的的剪切模量,探讨该技术对低龄先天性肌斜颈患儿的诊断价值。方法回顾性纳入64名先天性肌斜颈患儿及20名健康婴幼儿。应用二维超声及剪切波弹性成像技术在受试者双侧胸锁乳突肌最厚处分别测量胸锁乳突肌厚度及剪切模量,并计算双侧胸锁乳突肌厚度的差值、比值以及剪切模量的差值与比值。结果患侧胸锁乳突肌厚度、患侧胸锁乳突肌剪切模量,胸锁乳突肌厚度差值与比值,剪切模量差值与比值等6指标在患者群体与对照组间具有统计学差异( P <0.05)。在患者组中,头颈部倾斜角度小于15°组及15°至30°组间上述6指标亦具有统计学差异( P <0.05)。结论二维超声与剪切波弹性成像技术在低龄CMT患儿临床辅助诊断中具有较高的价值。患侧胸锁乳突肌厚度、患侧胸锁乳突肌剪切模量,双侧胸锁乳突肌厚度差值与比值,双侧胸锁乳突肌剪切模量差值与比值均可作为超声诊断参数。

Objective To measure the shear modulus of the sternocleidomastoid muscle (SCM) by real-time shear wave elastrography(SWE)and determine whether SWE could be used to diagnose congenital muscular torticollis (CMT) in younger infant. Methods 64 younger infants with a definitive clinical diagnosis of CMT and 20 healthy volunteers were enrolled in this study.At the thickest location of SCM,we measured the thicknesses of the involved and contralateral SCM and their difference and ratio by two-dimension ultrasound,and shear modulus data of the involved and contralateral SCM and their difference and ratio by SWE. Results The thickness and shear modulus of involved SCM,and their differences and ratios between involved and contralateral SCM differed significantly between the patient and control groups ( P <0.05).CMT patients in 15 to 30 degree of the passive range of motion deficit in neck rotation group showed higher thickness and SWE scores than those of the <15 degree of the passive range of motion deficit group. Conclusion 2D ultrasound and SWE appears to be a highly valuable diagnostic technique and is helpful for the diagnosis of CMT in younger infants.The thicknesses and shear modulus of the involved SCM,and their difference and ratio were effective diagnostic metrics for CMT diagnosis.