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Magnetic resonance imaging as a determinant for surgical release of congenital muscular torticollis: correlation with the histopathologic findings.

Hwang JH, Lee HB, Kim JH, Park MC, Kwack KS, Han JD, Yim SY - Ann Rehabil Med (2012)

Bottom Line: 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.The histopathologic findings and MRI findings showed good correlation in terms of the amount of fibrosis 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.

View Article: PubMed Central - PubMed

Affiliation: The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon 443-721, Korea.

ABSTRACT

Objective: (1) To present the magnetic resonance imaging (MRI) findings 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 findings 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. The MRI findings 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. The eighteen non-surgical candidates showed only enlargement of the SCM without low signal intensity within the SCM. The histopathologic findings showed interstitial fibrosis and/or the presence of aberrant tendon-like excessive dense connective tissue that was either well-arranged or disorganized.

Conclusion: The histopathologic findings and MRI findings showed good correlation in terms of the amount of fibrosis 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.

No MeSH data available.


Related in: MedlinePlus

The algorithm for enrollment of subjects from January 2009 to October 2009.
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Figure 1: The algorithm for enrollment of subjects from January 2009 to October 2009.

Mentions: Among the subjects who came to our medical center for abnormal posture of the head and neck from January 2009 to October 2009, the subjects who met all of the following criteria were included in this study: (1) the subjects were diagnosed with CMT according to the diagnostic criterion of CMT mentioned below, (2) neck MRI without contrast for CMT was taken when the subjects were 4 months old or older, and (3) there was a follow-up period of 6 months or more since taking neck MRI. Therefore, all the subjects were 10 months old or older at the time of this study. We made an algorithm to show the enrollment of subjects in this study (Fig. 1).


Magnetic resonance imaging as a determinant for surgical release of congenital muscular torticollis: correlation with the histopathologic findings.

Hwang JH, Lee HB, Kim JH, Park MC, Kwack KS, Han JD, Yim SY - Ann Rehabil Med (2012)

The algorithm for enrollment of subjects from January 2009 to October 2009.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3400870&req=5

Figure 1: The algorithm for enrollment of subjects from January 2009 to October 2009.
Mentions: Among the subjects who came to our medical center for abnormal posture of the head and neck from January 2009 to October 2009, the subjects who met all of the following criteria were included in this study: (1) the subjects were diagnosed with CMT according to the diagnostic criterion of CMT mentioned below, (2) neck MRI without contrast for CMT was taken when the subjects were 4 months old or older, and (3) there was a follow-up period of 6 months or more since taking neck MRI. Therefore, all the subjects were 10 months old or older at the time of this study. We made an algorithm to show the enrollment of subjects in this study (Fig. 1).

Bottom Line: 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.The histopathologic findings and MRI findings showed good correlation in terms of the amount of fibrosis 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.

View Article: PubMed Central - PubMed

Affiliation: The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon 443-721, Korea.

ABSTRACT

Objective: (1) To present the magnetic resonance imaging (MRI) findings 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 findings 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. The MRI findings 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. The eighteen non-surgical candidates showed only enlargement of the SCM without low signal intensity within the SCM. The histopathologic findings showed interstitial fibrosis and/or the presence of aberrant tendon-like excessive dense connective tissue that was either well-arranged or disorganized.

Conclusion: The histopathologic findings and MRI findings showed good correlation in terms of the amount of fibrosis 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.

No MeSH data available.


Related in: MedlinePlus