摘要: |
目的:探讨超声二维剪切波弹性成像及实时组织弹性成像对儿童先天性肌性斜颈的诊断及疗效评估。方法:选取105例疑似小儿先天性肌性斜颈患儿的临床资料进行回顾性分析,研究时间为2017年2月至2020年2月,经病理证实为先天性肌性斜颈共52例(肿块型33例、弥漫型19例);均给予超声二维剪切波弹性成像及实时组织弹性成像,评估检查后的敏感性、特异性、约登指数、cut-off值,分析Emean值与SR值的ROC曲线,以及评估治疗后的Emean值与SR值。结果:105例疑似小儿先天性肌性斜颈患儿经二维剪切波弹性成像技术检测后其阳性预测值为96.14%,阴性预测值为96.23%;与病理结果齐同(P>0.05)。经实时组织弹性成像技术检测后其阳性预测值为80.77%,阴性预测值为81.13%;低于病理结果(P<0.05)。52例先天性肌性斜颈患儿经二维剪切波弹性成像技术检测后肿块型共32例、弥漫型共18例;经实时组织弹性成像技术检测后肿块型共30例、弥漫型共12例;两组比较存在显著差异(P<0.05)。肿块型与弥漫型的Emean值、SR比值高于健侧(P<0.05); 肿块型Emean值、SR比值低于弥漫型(P<0.05)。 Emean值曲线下面积AUC值为(0.975,P<0.05),敏感性94.70%,特异度94.10%,约登指数0.888,cut-off值24.725;SR比值曲线下面积AUC值为(0.922,P<0.05),敏感性100.00%,特异度77.60%,约登指数0.776,cut-off值2.785。手术治疗的Emean值、SR比值低于非手术治疗(P<0.05)。52例先天性肌性斜颈患儿经非手术治疗后Emean值为(20.21±1.21),SR比值为(3.02±0.45);与治疗前相比无统计学意义(P>0.01);均转为手术治疗,手术治疗后Emean值为(8.23±1.06),SR比值为(0.67±0.14),均低于治疗前(P<0.05)。结论:二维剪切波弹性成像技术与实时组织弹性成像技术均能为临床诊断提供参考价值,但前者诊断确诊率更高。 |
关键词: 二维剪切波弹性成像技术 实时组织弹性成像技术 儿童 先天性肌性斜颈 |
DOI: |
投稿时间:2020-12-24修订日期:2021-01-13 |
基金项目: |
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Two-dimensional ultrasound shear wave elastography and real-time tissue elastography in the diagnosis and efficacy evaluation of congenital muscular torticollis in children |
Li Yaqian,Xu Ting,Jia Bentao,Xu Ci |
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Abstract: |
Objective: To investigate the diagnosis and efficacy evaluation of ultrasound two-dimensional shear wave elastography and real-time tissue elastography in children with congenital muscular torticollis. Methods: The clinical data of 105 children with suspected congenital muscular torticollis were selected for retrospective analysis. The study period was from February 2017 to February 2020. A total of 52 cases were confirmed pathologically as congenital muscular torticollis ( 33 cases of mass type and 19 cases of diffuse type); both were given ultrasound two-dimensional shear wave elastography and real-time tissue elastography to evaluate the sensitivity, specificity, Youden index, cut-off value after the examination, and analyze the emean value and ROC curve of SR value, and emean value and SR value after evaluation. Results: The positive predictive value of 105 children with suspected pediatric congenital muscular torticollis was 96.14% and the negative predictive value 96.23% after two-dimensional shear wave elastography detection; the same as the pathological results (P>0.05) . After real-time tissue elastography technology, the positive predictive value was 80.77%, and the negative predictive value was 81.13%, which was lower than the pathological result (P<0.05). A total of 52 children with congenital muscular torticollis were detected by two-dimensional shear wave elastography and there were 32 cases of mass type and 18 cases of diffuse type; a total of 30 cases of mass type and diffuse type were detected by real-time tissue elastography. 12 cases; there was a significant difference between the two groups (P<0.05). The Emean value and SR ratio of the mass type and the diffuse type were higher than those of the healthy side (P<0.05); the Emean value and SR ratio of the mass type were lower than that of the diffuse type (P<0.05). The AUC value of the area under the Emean value curve is (0.975, P<0.05), the sensitivity is 94.70%, the specificity is 94.10%, the Youden index is 0.888, and the cut-off value is 24.725; the AUC value of the area under the SR ratio curve is (0.922, P< 0.05), sensitivity 100.00%, specificity 77.60%, Youden index 0.776, cut-off value 2.785. The Emean value and SR ratio of surgical treatment were lower than those of non-surgical treatment (P<0.05). The Emean value of 52 children with congenital muscular torticollis after non-surgical treatment was (20.21±1.21), and the SR ratio was (3.02±0.45); there was no statistical significance compared with before treatment (P>0.01); For surgical treatment, the Emean value after surgery was (8.23±1.06), and the SR ratio was (0.67±0.14), which were both lower than before treatment (P<0.05). Conclusion: Both two-dimensional shear wave elastography technology and real-time tissue elastography technology can provide reference value for clinical diagnosis, but the former has a higher diagnosis rate. |
Key words: two-dimensional shear wave elastography technology real-time tissue elastography technology children congenital muscular torticollis |