Department of Ultrasound, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.
Skeletal Radiol. 2011 Feb;40(2):215-21. doi: 10.1007/s00256-009-0869-5. Epub 2010 Feb 6.
To evaluate the use of ultrasonography (US) in the diagnosis of gluteal muscle contracture (GMC) by analysis of its imaging characteristics.
Thirty-nine patients suspected of having GMC due to abnormal gait underwent pre-operative US.
The diagnosis of GMC was confirmed by surgery in 27 patients. Six patients were diagnosed with congenital hip dysplasia, and the remaining six patients were diagnosed with sciatic nerve damage, post-poliomyelitis sequelae, and myasthenia gravis. For the patients with GMC, US showed muscle thinning and hyperechoic strips (specific for muscular contracture) in the muscles involved. In three patients with GMC, the strips were integrated into muscle bundles, demonstrating both strong and weak sonographic echoes. The sensitivity and specificity of the diagnosis of GMC using the presence of strips were 88.9% and 83.3%, respectively, and using muscle thinning, the sensitivity and specificity were 92.6% and 50%, respectively. The contracture strips, as measured by US, were significantly smaller than the actual measurements at the time of surgery, but there was a significant correlation between the two measurements (r = 0.814, P < 0.01). The highest detection rate of GMC by US was found in the gluteus maximus muscle (91.8%), and the lowest rate was found in the piriformis muscle (52.9%).
Ultrasonography is a valuable tool for the diagnosis of GMC, especially for the detection of specific contracture strips in involved muscles. Its role in the pre-operative diagnosis of GMC also provides surgical planning that can guide subsequent treatment.
通过分析超声成像特征，评价超声在臀肌挛缩（GMC）诊断中的应用。
39 例因步态异常疑似 GMC 的患者术前接受了超声检查。
27 例患者经手术确诊为 GMC，6 例患者诊断为先天性髋关节发育不良，其余 6 例患者诊断为坐骨神经损伤、脊髓灰质炎后遗症和重症肌无力。对于 GMC 患者，超声显示受累肌肉变薄和高回声条带（提示肌肉挛缩）。3 例 GMC 患者的条带融合成肌束，表现为强回声和弱回声。使用条带存在诊断 GMC 的灵敏度和特异度分别为 88.9%和 83.3%，使用肌肉变薄的灵敏度和特异度分别为 92.6%和 50%。超声测量的挛缩条带明显小于手术时的实际测量值，但两者之间存在显著相关性（r=0.814，P<0.01）。超声对 GMC 的最高检出率见于臀大肌（91.8%），最低见于梨状肌（52.9%）。
超声是诊断 GMC 的一种有价值的工具，尤其适用于检测受累肌肉中的特定挛缩条带。其在 GMC 术前诊断中的作用也为手术计划提供了指导，从而有助于后续治疗。
