Magnetic Resonance Imaging as a Determinant for Surgical Release of Congenital Muscular Torticollis: Correlation with the Histopathologic Findings
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참고문헌
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초록
Objective (1) To present the magnetic resonance imaging (MRI) fi ndings of congenital muscular torticollis (CMT)of subjects who underwent surgical release and subjects who showed a good prognosis with stretching exercises and (2) to correlate the MRI findings with the histopathologic findings of CMT for subjects who underwent surgical release in order to examine the hypothesis that the MRI fi ndings of CMT can be used as a determinant to perform surgical release of CMT. Method The neck MRI findings of 33 subjects who underwent surgical release for CMT were compared with those of 18 subjects who were successfully managed only with conservative management. Th e MRI fi ndings were correlated with the histopathologic sections of the CMT mass. Results All 33 subjects (100%) who underwent surgical release showed one or more low signal intensities within the involved sternocleidomastoid muscle (SCM) on the T1- and T2-weighted images of neck MRI. Th e eighteen non-surgical candidates showed only enlargement of the SCM without low signal intensity within the SCM. Th e histopathologic fi ndings showed interstitial fi brosis and/or the presence of aberrant tendon-like excessive dense connective tissue that was either well-arranged or disorganized. Conclusion Th e histopathologic fi ndings and MRI fi ndings showed good correlation in terms of the amount of fi brosis and aberrant dense connective tissue within the SCM. If multiple or large low signal intensities within the SCM are noted, we think that surgical release should be considered.
Abstract
Objective (1) To present the magnetic resonance imaging (MRI) fi ndings of congenital muscular torticollis (CMT)of subjects who underwent surgical release and subjects who showed a good prognosis with stretching exercises and (2) to correlate the MRI findings with the histopathologic findings of CMT for subjects who underwent surgical release in order to examine the hypothesis that the MRI fi ndings of CMT can be used as a determinant to perform surgical release of CMT. Method The neck MRI findings of 33 subjects who underwent surgical release for CMT were compared with those of 18 subjects who were successfully managed only with conservative management. Th e MRI fi ndings were correlated with the histopathologic sections of the CMT mass. Results All 33 subjects (100%) who underwent surgical release showed one or more low signal intensities within the involved sternocleidomastoid muscle (SCM) on the T1- and T2-weighted images of neck MRI. Th e eighteen non-surgical candidates showed only enlargement of the SCM without low signal intensity within the SCM. Th e histopathologic fi ndings showed interstitial fi brosis and/or the presence of aberrant tendon-like excessive dense connective tissue that was either well-arranged or disorganized. Conclusion Th e histopathologic fi ndings and MRI fi ndings showed good correlation in terms of the amount of fi brosis and aberrant dense connective tissue within the SCM. If multiple or large low signal intensities within the SCM are noted, we think that surgical release should be considered.
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