Ann Rehabil Med.  2016 Feb;40(1):28-33. 10.5535/arm.2016.40.1.28.

Clinical Usefulness of Sonoelastography in Infants With Congenital Muscular Torticollis

Affiliations
  • 1Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Korea. zilee@hanmail.net
  • 2Department of Radiology, Daegu Fatima Hospital, Daegu, Korea.

Abstract


OBJECTIVE
To evaluate the clinical usefulness of sonoelastography in infants with congenital muscular torticollis (CMT).
METHODS
The medical records of 215 infants clinically diagnosed with CMT were retrospectively reviewed. Fifty-three infants met the inclusion criteria as follows: 1) infants diagnosed as CMT with a palpable neck mass before 3 months of age, 2) infants who were evaluated initially by both B-mode ultrasonography and sonoelastography, and 3) infants who had received physical therapy after being diagnosed with CMT. We checked the thickness of the sternocleidomastoid (SCM) muscles in B-mode ultrasonography, strain ratio of the SCM muscles in sonoelastography, and treatment duration. We evaluated the correlation between the treatment duration and the following factors: SCM muscle thickness, ratio of SCM muscle thickness on the affected to unaffected side (A/U ratio), and strain ratio.
RESULTS
Both the thickness of the affected SCM muscle and the A/U ratio did not show significant correlation with the treatment duration (p=0.66, p=0.90). The strain ratio of the affected SCM muscle was significantly greater than that of the unaffected SCM muscle (p<0.001), and the strain ratio showed significant correlation with the treatment duration (p=0.001).
CONCLUSION
Sonoelastography may be a useful adjunctive tool to B-mode ultrasonography for evaluating infants with CMT, especially when predicting their rehabilitation outcomes.

Keyword

Congenital muscular torticollis; Sonoelastography; Prognosis

MeSH Terms

Elasticity Imaging Techniques*
Humans
Infant*
Medical Records
Muscles
Neck
Prognosis
Rehabilitation
Retrospective Studies
Torticollis*
Ultrasonography

Figure

  • Fig. 1 Transverse view of the sternocleidomastoid (SCM) muscle in B-mode ultrasonogram. White arrow indicates thickness of the SCM muscle.

  • Fig. 2 Transverse view of sternocleidomastoid (SCM) muscle in B-mode ultrasonogram (A) and sonoelastogram (B). Each yellow dotted circle is the cross-sectional area of SCM muscle. In sonoelastogram (B), the colors ranging from red (soft) to blue (hard) represent relative stiffness of the tissue. Red circle (strain 1) indicates region of interest (ROI) of subcutaneous tissue (reference tissue), and green circle (strain 2) is ROI of SCM muscle.

  • Fig. 3 Correlation between strain ratio and treatment duration in a scatter plot. *p<0.01, Spearman correlation test.


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