儿童臀肌挛缩症的CT诊断

CT diagnosis of gluteal muscle contracture in children

目的 探讨儿童臀肌挛缩症的CT表现。方法 对 6 1例经CT诊断为臀肌挛缩症 ,并经手术病理证实的患儿进行研究 ,并与 2 0例正常臀肌的CT表现作对照。结果 在 6 1例臀肌挛缩症中 ,5 7例 (93 4 % )是双侧挛缩 ,4例 (6 6 % )是单侧 ;CT主要表现 :(1)臀肌体积缩小 ,118侧(10 0 0 % )臀大肌体积缩小 ,16侧 (13 6 % )臀中肌体积缩小 ;12侧 (10 2 % )梨状肌体积缩小 ;4侧(3 4 % )臀小肌体积缩小 ;4侧 (3 4 % )髋关节后方关节囊挛缩。 (2 )注射点区臀肌钙化、坏死。 95侧(80 5 % )臀肌有钙化 ,2 4侧 (2 0 3% )臀肌有斑片状坏死。 (3)条索状挛缩带 ,81条位于臀大肌外侧 ,从臀大肌外上缘到髂筋束 ,36条位于臀大肌骶骨侧。 (4 )肌间隙增宽 ,轻度 38侧 (32 2 % ) ,中度 5 3侧(4 4 9% ) ,重度 2 7侧 (2 2 9% )。结论 CT扫描能正确诊断臀肌挛缩症 ,明确病变范围及程度 ,对术前评估有重要价值。

Objective To investigate the CT manifestations of gluteal muscle contracture (GMC) in children.Methods Sixty-one cases of GMC diagnosed by CT and proved by surgery and pathology were studied with 20 cases of non-GMC as the control group.Results 57 cases (93.4%) were bilateral contracture and 4 cases (6.6%) were unilateral contracture in 61 cases of GMC; The main CT manifestations were as follows: (1) gluteal muscle volume shrunk.there were 118 (100.0%) sides of gluteus maximus contracture,16 (13.6%) sides of gluteus medius contracture,12 (10.2%) sides of piriformis contracture,4 (3.4%) sides of gluteus minimus contracture,4 (3.4%) sides of capsula articularis contracture; (2) calcification and necrosis in injection zones.There were 95(80.5%) sides of gluteal calcification and 24(20.3%) sides of gluteal necrosis; (3) stripe crispation fascia.There were 81 stripes crispation fascia located outboard laterals of gluteus maximus,36 located inboard laterals of the latter; (4) gluteal muscle clearance widened.There were 38 (32.2%) sides of light degree gluteal muscle contracture,53 (44.9%) sides of middle degree,and 27 (22.9%) sides of heavy degree.Conclusion CT can accurately diagnose GMC and it plays an important role in the evaluation of pathological extent and degree of GMC.