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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

Typical neck MRI findings of subjects who show a good response to stretching exercises. Thickened sternocleidomastoid muscles do not have low signal intensities (arrows).
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Figure 3: Typical neck MRI findings of subjects who show a good response to stretching exercises. Thickened sternocleidomastoid muscles do not have low signal intensities (arrows).

Mentions: All 33 subjects who underwent surgical release (100%) showed one or more low signal intensities within the involved SCM on both the T1- and T2-weighted images of neck MRI. Compared to the MRI findings of subjects that did not have low signal intensities within the SCM (Fig. 3), the images of these subjects showed the typical findings of low signal intensities within the SCM (Fig. 4). Eighteen subjects with CMT were successfully managed with physical therapy including stretching exercise, ending up with restoration of the full range of motion of the neck and decrease of the size of the mass.


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)

Typical neck MRI findings of subjects who show a good response to stretching exercises. Thickened sternocleidomastoid muscles do not have low signal intensities (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Typical neck MRI findings of subjects who show a good response to stretching exercises. Thickened sternocleidomastoid muscles do not have low signal intensities (arrows).
Mentions: All 33 subjects who underwent surgical release (100%) showed one or more low signal intensities within the involved SCM on both the T1- and T2-weighted images of neck MRI. Compared to the MRI findings of subjects that did not have low signal intensities within the SCM (Fig. 3), the images of these subjects showed the typical findings of low signal intensities within the SCM (Fig. 4). Eighteen subjects with CMT were successfully managed with physical therapy including stretching exercise, ending up with restoration of the full range of motion of the neck and decrease of the size of the mass.

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