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·头颈疾病·

先天性斜颈的彩色多普勒超声征象及其临床意义

作者:王晓波 陈 忠 邓连桂 黄佩贤 梁爱容

所属单位:南方医科大学附属新会医院(新会区人民医院)超声科 (广东 江门 529000)

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摘要

目的 探讨先天性斜颈的超声表现和诊断价值。方法 对20例先天性斜颈的患儿的彩色多普勒超声声像图进行回顾性 分析,总结其超声特点。结果 20例先天性斜颈中,男13例,女7例。年龄3周至7+月。左侧12例(60%,12/20),右 侧8例(40%,8/20)。单发肿物15例(75%,15/20),多发肿物5例(25%,5/20)。先天性斜颈的彩色多普勒超声表现: 胸锁乳突肌探及肿物,肿块最大径1.9cm-3.6cm,边界清晰或欠清晰,无明显包膜,呈椭圆形或圆形,肿块内部回 声均为不均质稍低或稍高回声。彩色多普勒显示15例肿块内部显示点条状血流信号,5例无明显血流信号,血流检 出率为75%(15/20)。脉冲多普勒可记录到低流速动脉血流频谱,收缩期峰值速度6.51-12.30 cm/s,舒张末期速度 (1.05±3.20)cm/s 。结论 彩色多普勒超声诊断先天性斜颈经济、无创、准确,可作为首选的诊断方法。

Objective To investigate the ultrasound manifestations and diagnosis value of congenital torticollis. Methods Color Doppler ultrasound images of 20 cases with congenital muscular torticollis in children were retrospectively analyzed and summarized. Results 20 cases of congenital torticollis, 13 cases of male, 7 cases of female. Age from 3 weeks to 7+ months. Left side in 12 cases (60%, 12/20), right side in 8 cases (40%, 8/20). Single mass in 15 cases (75%, 15/20), multiple masses in 5 cases (25%, 5/20). Color doppler ultrasound manifestations of congenital muscular torticollis: the tumor was found in the quadrigeminus capitis, the maximum diameter of the tumor was 1.9cm~3.6cm, the boundary clear or not clear, oval or round, the internal echo of the tumor was slightly lower or slightly higher. Color doppler showed that 15 cases of the internal display of the point of the blood flow signal, 5 cases without obvious blood flow signal, blood flow detection rate was 75% (15/20). Pulse Doppler can record low velocity arterial flow spectrum, peak systolic velocity 6.51-12.30cm/s, end diastolic velocity (1.05±3.20)cm/s. Conclusion Color Doppler ultrasound is a noninvasive, economic and accurate method in the diagnosis of congenital torticollis, and it can be used as the preferred diagnostic method.

【关键词】先天性斜颈;彩色多普勒;超声

【中图分类号】R445.1

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.04.002

前言

先天性斜颈系指出生后不久就发现颈部向一侧倾 斜的畸形,先天性斜颈分为肌性斜颈,以及骨性斜 颈。绝大部分是肌源性斜颈,骨源性斜颈非常罕见。 最近,肌源性斜颈发病率有上升趋势,有文献报告在 新生儿中有高达16%发病率[1]。先天性斜颈的真正原 因至今仍不明了。临床表现主要是为颈部触及肿块以 及斜颈。本文研究分析总结了20例先天性斜颈的彩色 多普勒超声表现,以探讨其诊断价值。