小儿先天性肌性斜颈二维超声、超声剪切波弹性成像技术及超微血管成像技术的超声表现  

Ultrasonic manifestation of pediatric congenital muscular torticollis with two-dimensional ultrasonography,shear wave elastography and superb microvascular imaging

作　　者：张云[1] 强群[1] 吕永鑫[1] 刘佳[1] ZHANG Yun;QIANG Qun;LYU Yongxin;LIU Jia(Department of Ultrasound Medical Imaging,Gansu Provincial Hospital of Traditional Chinese Medicine,Gansu Province,Lanzhou 730050,China)

机构地区：[1]甘肃省中医院超声医学影像科,甘肃兰州730050

出　　处：《妇儿健康导刊》2023年第15期11-13,21,F0003,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：甘肃省兰州市科技计划项目(2021-1-89)。

摘　　要：目的探讨小儿先天性肌性斜颈(CMT)二维超声及超声剪切波弹性成像(SWE)技术、超微血管成像(SMI)技术的超声表现及量化诊断价值。方法选取2021年8月至2022年12月于甘肃省中医院针灸推拿科门诊就诊的可疑CMT患儿80例,分析其胸锁乳突肌(SCM)肿块的大小,测定SWE及SMI等指标。结果80例患儿中,CMT患儿63例(78.7%),体位姿势型患儿17例(21.3%);63例CMT患儿中,肿块型45例(71.4%),肌肉紧张型18例(28.6%);肿块型厚度8.0~34.4 mm,累及范围39.0~53.4 mm,挛缩长度4.2~13.8 mm;肌肉紧张型厚度3.5~12.7 mm,累及范围25.2~32.2 mm,挛缩长度2.4~15.7 mm。SWE检测SCM健侧弹性图像为均匀蓝色,杨氏模量最大值(E_(max))为(26.84±2.93)kPa,平均值(E_(mean))为(16.04±2.24)kPa;患侧SCM弹性图像为亮蓝色与黄绿红色相间混合,E_(max)为(102.32±3.84)kPa,E_(mean)为(43.85±6.32)kPa。患侧与健侧E_(max)、E_(mean)比较,差异有统计学意义(P<0.05)。双侧E_(max)比值(Eratio)为(3.82±0.75)kPa。SMI检测健侧SCM为Ⅰ级,内见散在分布星点状彩色血流信号;肿块型SCM为Ⅲ级,内部见点条状、线样血流信号;肌肉紧张型SCM为Ⅱ级,内部可以检测到点状或短杆状血流信号。结论超声二维声像图结合SWE及SMI检测CMT,可以准确得出清晰的影像学表现,量化SCM的硬度,观察血流情况,对后续治疗进行动态评测,具有较高的价值。Objective To investigate the ultrasonic manifestation and quantitative diagnostic value of pediatric congenital muscular torticollis(CMT)with two-dimensional ultrasonography,shear wave elastography(SWE)and superb microvascular imaging(SMI).Methods A total of 80 children with suspected CMT who visited the outpatient department of Acupuncture and Massage of Gansu Provincial Hospital of Traditional Chinese Medicine from August 2021 to December 2022 were selected,the size of the sternocleidomastoid muscle(SCM)mass was analyzed,and the indexes of SWE and SMI were measured.Results Of the 80 cases,63 were CMT(78.7%),17 were posture type CMT(21.3%).Of the 63 cases,45 were mass type(71.4%),18 were muscle tension type(28.6%).The thickness of mass type was 8.0-34.4 mm,the involved range was 39.0-53.4 mm,the length of contracture was 4.2-13.8 mm.The muscle tension type was 3.5-12.7 mm,the involved range was 25.2-32.2 mm,the length of contracture was 2.4-15.7 mm.SWE detected that the elasticity image of the healthy side of SCM was uniform blue,E_(max)was(26.84±2.93)kPa,E_(mean)was(16.04±2.24)kPa.The elastic image of the affected side was bright blue mixed with yellow-green-red,E_(max)was(102.32±3.84)kPa,E_(mean)was(43.85±6.32)kPa.Comparison of E_(max)and E_(mean)between the affected side and the healthy side showed statistically significant differences(P<0.05).Eratio was(3.82±0.75)kPa.SMI detection showed that SCM in the contralateral side was gradeⅠ,with dotted and scattered color blood flow signals.The mass type of SCM was gradeⅢ,and the point or short rod blood flow signal could be detected inside.The muscle tension type of SCM was gradeⅡ,in which punctate or short rod-shaped blood flow signals could be detected.Conclusion Two-dimensional ultrasonography combined with SWE and SMI for CMT can obtain clear imaging findings,quantify the stiffness of the SCM,observe blood flow,and dynamically evaluate the su bsequent treatment,which has high value.

关 键 词：先天性肌性斜颈 二维超声 超声剪切波弹性成像 超微血管成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]