Quantitative Analysis of Magnetic Resonance Imaging of the Neck and Its Usefulness in Management of Congenital Muscular Torticollis
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To quantify magnetic resonance imaging (MRI) findings of congenital muscular torticollis (CMT) and to demonstrate the usefulness of quantitative MRI findings in the management of CMT.Methods This was a retrospective study of 160 subjects with CMT who had undergone neck MRI at the age of 48 months or younger at a tertiary medical center. Among the 160 subjects, 54 had undergone surgical release of CMT and 106 subjects had not undergone surgery. For the quantitative analysis, the ratios of area and intensity of the MRI findings were measured and compared between the two groups (ratio of area = the largest cross-sectional area of the SCM with CMT − the cross-sectional area of the contralateral SCM without CMT / the cross-sectional area of the contralateral SCM without CMT; ratio of intensity = the mean gray color intensity of the contralateral SCM without CMT − the lowest mean gray color intensity of the SCM with CMT / the mean gray color intensity of the contralateral SCM without CMT). Receiver operating characteristic (ROC) curve analysis was conducted for the ratios of area and intensity in order to find the optimal cutoff value for determining the need for surgery in CMT cases.Results The ratios of area and intensity were significantly higher in the surgical group than in the non-surgical group (p≤0.001), suggesting that the sternocleidomastoid muscle (SCM) was thicker and darker in the surgical group than in the non-surgical group. The optimal cutoff value for the ratio of area was 0.17 and that for the ratio of intensity was 0.05. All subjects with a ratio of intensity less than 0.03 belonged to the non-surgical group, and all subjects with a ratio of intensity greater than 0.16 were categorized in the surgical group.Conclusion The quantitative MRI findings, i.e., ratios of area and intensity, may provide a guideline for deciding the need for surgical intervention in CMT patients. Further prospective studies are required to verify these findings.
Abstract
Objective To quantify magnetic resonance imaging (MRI) findings of congenital muscular torticollis (CMT) and to demonstrate the usefulness of quantitative MRI findings in the management of CMT.Methods This was a retrospective study of 160 subjects with CMT who had undergone neck MRI at the age of 48 months or younger at a tertiary medical center. Among the 160 subjects, 54 had undergone surgical release of CMT and 106 subjects had not undergone surgery. For the quantitative analysis, the ratios of area and intensity of the MRI findings were measured and compared between the two groups (ratio of area = the largest cross-sectional area of the SCM with CMT − the cross-sectional area of the contralateral SCM without CMT / the cross-sectional area of the contralateral SCM without CMT; ratio of intensity = the mean gray color intensity of the contralateral SCM without CMT − the lowest mean gray color intensity of the SCM with CMT / the mean gray color intensity of the contralateral SCM without CMT). Receiver operating characteristic (ROC) curve analysis was conducted for the ratios of area and intensity in order to find the optimal cutoff value for determining the need for surgery in CMT cases.Results The ratios of area and intensity were significantly higher in the surgical group than in the non-surgical group (p≤0.001), suggesting that the sternocleidomastoid muscle (SCM) was thicker and darker in the surgical group than in the non-surgical group. The optimal cutoff value for the ratio of area was 0.17 and that for the ratio of intensity was 0.05. All subjects with a ratio of intensity less than 0.03 belonged to the non-surgical group, and all subjects with a ratio of intensity greater than 0.16 were categorized in the surgical group.Conclusion The quantitative MRI findings, i.e., ratios of area and intensity, may provide a guideline for deciding the need for surgical intervention in CMT patients. Further prospective studies are required to verify these findings.
참고문헌 (20)
- Bredenkamp JK, "Congenital muscular torticollis: a spectrum of disease", Arch Otolaryngol Head Neck Surg, 116, pp.212~216 (1990)
- Chen MM, "Predictive model for congenital muscular torticollis:analysis of 1021 infants with sonography", Arch Phys Med Rehabil, 86, pp.2199~2203 (2005)
- Cheng JC, "Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants: a prospective study of eight hundred and twenty-one cases", J Bone Joint Surg Am, 83A, pp.679~687 (2001)
- Cheng JC, "Outcome of surgical treatment of congenital muscular torticollis", Clin Orthop Relat Res, (362), pp.190~200 (1999)
- Yim SY, "Integrative analysis of congenital muscular torticollis:from gene expression to clinical significance", BMC Med Genomics, 6(Suppl 2), pp.S10~ (2013)
- Jee Hyun Hwang, "Magnetic Resonance Imaging as a Determinant for Surgical Release of Congenital Muscular Torticollis: Correlation with the Histopathologic Findings", Annals of Rehabilitation Medicine, 36(3), pp.320~327 (2012), 대한재활의학회[DOI]
- 한재덕, "The Thickness of the Sternocleidomastoid Muscle as a Prognostic Factor for Congenital Muscular Torticollis", Annals of Rehabilitation Medicine, 35(3), pp.361~368 (2011), 대한재활의학회
- Yim SY, "The laryngeal cough reflex in congenital muscular torticollis:is it a new finding?", Am J Phys Med Rehabil, 89, pp.147~152 (2010)
- Seung Jae Lee, "Comparison of Clinical Severity of Congenital Muscular Torticollis Based on the Method of Child Birth", Annals of Rehabilitation Medicine, 35(5), pp.641~647 (2011), 대한재활의학회
- Binder H, "Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases", Arch Phys Med Rehabil, 68, pp.222~225 (1987)
- Canale ST, "Congenital muscular torticollis: a long-term follow-up", J Bone Joint Surg Am, 64, pp.810~816 (1982)
- Entel RJ, "Congenital muscular torticollis:magnetic resonance imaging and ultrasound diagnosis", J Neuroimaging, 7, pp.128~130 (1997)
- De Smet AA., "Magnetic resonance findings in skeletal muscle tears", Skeletal Radiol, 22, pp.479~484 (1993)
- De Smet AA, "Magnetic resonance imaging of muscle tears", Skeletal Radiol, 19, pp.283~286 (1990)
- Lidge RT, "Congenital muscular torticollis: etiology and pathology", J Bone Joint Surg Am, 39A, pp.1165~1182 (1957)
- Suzuki S, "The aetiological relationship between congenital torticollis and obstetrical paralysis", Int Orthop, 8, pp.175~181 (1984)
- Davids JR, "Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome", J Pediatr Orthop, 13, pp.141~147 (1993)
- Cheng JC, "Infantile torticollis: a review of 624cases", J Pediatr Orthop, 14, pp.802~808 (1994)
- Cheng JC, "The clinical presentation and outcome of treatment of congenital muscular torticollis in infants: a study of 1,086 cases", J Pediatr Surg, 35, pp.1091~1096 (2000)
- Parikh SN, "Magnetic resonance imaging in the evaluation of infantile torticollis", Orthopedics, 27, pp.509~515 (2004)