title: Diagnostic value of real-time sonoelastography in congenital muscular torticollis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the possible use of real-time sonoelastography in infants with congenital muscular torticollis for predicting treatment outcomes.
  
  
  METHODS
  The study included 20 infants with a sternocleidomastoid muscle thickness of greater than 10 mm, a sonoelastographic score of 4, and involvement of the entire length of the muscle (group 1) and 30 infants with a sternocleidomastoid muscle thickness of less than 10 mm, a sonoelastographic score of 3, and involvement of only part of the muscle (group 2). A physiatrist performed B-mode sonography and sonoelastography together, measured the thickness of the sternocleidomastoid muscle, and calculated the cross-sectional area of the involved muscle in both groups. On color scale sonoelastography, the sonoelastographic score of the sternocleidomastoid muscle was graded from 1 (purple to green: soft) to 4 (red: stiff), and the color histogram of the muscle was subsequently analyzed.
  
  
  RESULTS
  The thickness and cross-sectional area of the sternocleidomastoid muscles in group 1 were significantly greater than those in group 2 (P = .001). On the color histograms, the median red pixel values in group 1 were significantly greater than those in group 2 (P = .001). In group 1, the mass in the affected muscle completely disappeared in 16 infants (80%), and a residual mass was detected in 4 (20%) on B-mode sonography at the final outcome. However, in group 2, the mass in the affected sternocleidomastoid muscle completely disappeared in all of the infants.
  
  
  CONCLUSIONS
  These findings suggest that real-time sonoelastography, although an ancillary technique to conventional sonography, may predict treatment outcomes of congenital muscular torticollis.
authors.affiliation: Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Nam-Gu, Daegu, Korea. coolkwon@cu.ac.kr
authors.forename: Dong Rak
authors.initials: DR
authors.lastname: Kwon
authors.forename: Gi Young
authors.initials: GY
authors.lastname: Park
mesh_terms: D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014103:Torticollis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome