VTIQ在小儿先天性肌性斜颈诊治中的应用价值

Value of VTIQ in the Diagnosis and Treatment of Congenital Muscular Torticollis in Children

目的探讨声触诊组织定量成像技术(virtual touch tissue imaging quantification,VTIQ)对诊断小儿先天性肌性斜颈(congenital muscular torticollis,CMT)的价值,并监测其手法按摩治疗效果,初步探讨其对治疗方案选择的临床应用价值。方法收集在笔者医院门诊就诊的CMT患儿62例,而后对确诊CMT进行非手术手法按摩推拿治疗后的患儿62例进行随访,并收集同一时期在笔者医院进行住院预行手术治疗的CMT患儿23例。均对其进行常规超声检查和VTIQ检查。结果62例患儿患侧胸锁乳突肌的剪切波速度(SWV)与健侧胸锁乳突肌的SWV比较,差异有统计学意义(P<0.01);62例手法治疗后好转的患儿患侧与健侧的胸锁乳突肌SWV比较,差异无统计学意义(P>0.05),治疗前后患侧胸锁乳突肌SWV比较,差异有统计学意义(P<0.01)。预行手术治疗23例患儿患侧与健侧胸锁乳突肌SWV比较,差异有统计学意义(P<0.01),23例手术患儿与62例门诊患儿的患侧胸锁乳突肌SWV比较,差异有统计学意义(P<0.01)。结论VTIQ可以客观地评价患侧胸锁乳突肌的软硬度,有助于诊断小儿CMT,并对小儿CMT手法按摩推拿治疗的疗效监测上有较高的应用价值,对于指导选择手术治疗与否及选择时机,提供客观指标。

Objective To evaluate the clinical value of virtual touch tissue imaging quantification(VTIQ)in diagnosis of congenital muscular torticollis(CMT)in children,and to monitor the therapeutic effect of manipulation massage,and to discuss the clinical application value of this method in the selection of treatment program.Methods 62 children with CMT treated in the outpatient department of our hospital were collected,and then 62 children diagnosed with CMT treated with non-surgical manipulation massage were followed up,and 23 children with CMT treated with presurgical treatment in our hospital in the same period were collected.Conventional ultrasonic examination and VTIQ examination were performed.Results The shear wave velocity(SWV)of the sternocleidomastoid muscle in 62 patients had significant difference with the SWV of the contralateral sternocleidomastoid muscle(P<0.01).The 62 patients were treated with the affected side and the healthy side.There was no significant difference in SWV between the sternocleidomastoid muscles(P>0.05).There was significant difference in SWV between the sternocleidomastoid muscles before and after treatment(P<0.01).There were significant differences in SWV between the affected side and the contralateral sternocleidomastoid muscle in 23 patients(P<0.01).There were differences in the SWV of the sternocleidomastoid muscle between the 23 children and 62 outpatients.Statistical significance(P<0.01).Conclusion VTIQ can objectively judge the soft and hard parts of the lesions,and is helpful for diagnosing children′s CMT.It has a high application value in monitoring the therapeutic effect of pediatric CMT massage massage therapy.