The Application Of Ultrasonic Elastography In Diagnosing Infants With Congenital Muscular Torticollis

Objective To explore the application of ultrasonic elastography(UE) in diagnosing infants with congenital muscular torticollis(CMT).Methods Sixty-three infants that were suspect of torticollis was selected,all underwent conventional ultrasound and UE. All infants were lying on their back silently, with their head rotated contralaterally to the examined side. First, all infants underwent conventional and Doppler ultrasound with GE LOGIQ9, if there was a mass found in the neck, observe affected sternocleidomastoid muscle (SCM), measured the size of the mass if there was one,and figure out its internal echo structure and its how it associated with SCM,observe the thickness of two sides if there was no mass.Then apply color doppler technology, observed the rounding and inner blood flow of the mass. Then start tissues elastography imaging model,measured the strain value of mass core or the thickest part of affected SCM (E1),and the strain value of the corresponding part of the healthy contralateral (E2) as well,then calculated the ratio (E1/E2).Result Among sixty-three patients,there were forty with CMT,twenty three with non CMT. The UE image of non CMT patients showed green evenly distributed,with a little blue and red color,its average strain ration of suspected side of SCMs was 0.83±0.09,the E-ratio was 1.24±0.32.Forty patients with CMT showed the middle and lower third of involved SCM had become thicker or found low internal echo mass and slightly higher echo mass within the SCM.And its corresponding elastic ultrasonic images show the SCM thicking part was green and blue,blue distributed more,the average stain was 1.82±0.23,the E-ratio was 1.98±0.27.The AUC in ROC curve of applying UE strain ratio to diagnose CMT was 0.894,the best cutoff value was 1.97, the accuracy, sensitivity, specificity, negative predictive value, positive predictive value were 79.4%,75.0%,86.9%, 66.7%,90.9%, separately.Conclusion UE strain ratio is helpful in diagnosing CMT, and it has high value of application when rule out CMT. It also has important clinical value in selecting children who have CMT symptoms. It provides quantitative diagnose index using the E ratio of affected and unaffected SCM, so it has certain reference value for diagnosing CMT and is worth using widely.