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Clinical Efficacy of Real-Time Sonoelastography for the Follow-Up of Congenital Sternocleidomastoid Muscle Torticollis

대한영상의학회지 2020년 81권 1호 p.176 ~ 189
 ( Jeong Mi-Ri ) - Pusan National University Hospital Department of Radiology

 ( Lee In-Sook ) - Pusan National University Hospital Department of Radiology
신용범 ( Shin Yong-Beom ) - Pusan National University Hospital Department of Rehabilitation Medicine
 ( Song You-Seon ) - Pusan National University Hospital Department of Radiology
 ( Park Se-Kyoung ) - Kosin University Gospel Hospital Department of Radiology
 ( Song Jong-Woon ) - Inje University Haeundae Paik Hospital Department of Radiology
 ( Moon Jin-Il ) - Gyeongsang National University Changwon Hospital Department of Radiology

Abstract


Purpose: To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity.

Materials and Methods: Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis.

Results: Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor.

Conclusion: RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

키워드

Index terms Ultrasound; Sonoelastography; Muscles; Torticollis; Infant
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