摘要
目的:探讨高频超声定量评估小儿先天性肌性斜颈(CMT)患侧肌肉功能恢复状况的可行性。方法:收集80例CMT患儿,推拿治疗6个月后复查超声,测量双侧胸锁乳突肌收缩、舒张时中下段最大横断面的肌肉厚度变化值与横截面积变化值,并分别计算同一患儿双侧肌肉厚度变化值之差(D1)及肌肉横截面积变化值之差(D2)。根据临床疗效评估结果,将80例分为治愈组、好转组及无效组,比较3组间D1及D2差异;分析D1、D2与临床疗效评估结果间的相关性,以及D1诊断CMT患儿肌肉功能恢复正常的敏感度及特异度。结果:各组间D1值差异有统计学意义(P<0.01),而D2值差异无统计学意义(P>0.05)。所有患儿D1均为正值或0,与临床疗效评估间呈负相关,且相关性较好(r=-0.812,P<0.001)。D1值诊断CMT推拿治疗功能恢复正常的ROC曲线下面积为0.959(P<0.05),诊断阈值0.7 mm,敏感度82.61%(38/46)、特异度97.06%(33/34)。结论:同一患儿双侧胸锁乳突肌收缩与舒张时肌肉厚度变化值的差值可作为定量评估CMT患儿患肌功能恢复状况的有效指标。
Objective:To explore the feasibility of quantitative evaluation of muscle function recovery in children with congenital muscular torticollis(CMT)by high frequency ultrasound.Methods:80 children with CMT were collected.After half a year of massage treatment,ultrasound was used to measure the changes of muscle thickness and cross-sectional area(CSA)in the middle and lower section of bilateral sternocleidomastoid muscle during contraction and diastole of sternocleidomastoid muscle,and the difference of muscle thickness changes(D1)and CSA changes(D2)of bilateral muscles in the same child were calculated respectively.At the same time,the children were divided into the treatment group,the improvement group and the ineffective group according to the clinical efficacy evaluation.The differences of D1 and D2 among groups were compared,as well as the correlations and clinical efficacy evaluation were analyzed.The sensitivity and specificity of D1 in diagnosing of muscle function recovery were analyzed.Results:There was a significant difference in D1 among the groups(P<0.01),while no statistically significant difference in D2 among the groups(P>0.05).No children had negtive D1 values,and there was a negative correlation between D1 and clinical efficacy evaluation(r=-0.812,P<0.001).The AUC of diagnosing recovery of sternocleidomastoid function by D1 was 0.959(P<0.05),with the diagnostic threshold of 0.7 mm,and the sensitivity was 82.61%(38/46),and the specificity was 97.06%(33/34).Conclusion:The difference of muscle thickness changes during contraction and diastole of bilateral sternocleidomastoid in the same child can be used as an effective index to quantitatively evaluate the recovery of muscle function in children with CMT.
作者
沙晓溪
康佳
彭趣思
陈园园
胡敏
康彧
SHA Xiaoxi;KANG Jia;PENG Qusi;CHEN Yuanyuan;HU Min;KANG Yu(Department of Ultrasound,Affiliated Hospital of Chengdu University of TCM,Chengdu 610072,China)
出处
《中国中西医结合影像学杂志》
2021年第6期524-527,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
成都中医药大学基金支持(2016-D-YY-13)。
关键词
斜颈
超声检查
婴儿
推拿
Torticollis
Ultrasonography
Infant
Massage
