肩胛舌骨肌及其伴行神经超声表现

目的 观察肩胛舌骨肌(OM)及其伴行神经超声表现。方法 前瞻性纳入60名健康成年人共120侧肩颈部,以超声扫查双侧OM及其伴行周围神经,观察其超声表现。结果 超声声像图显示OM中间腱多位于胸锁乳突肌(SCM)中、后区深处,83侧显著型表现为强回声带,37侧非显著型表现为低回声细带,周围均见强回声腱膜。OM周围存在较多呈低回声的神经,包括颈袢、迷走神经、膈神经、臂丛、胸长神经(LTN)及肩胛上神经(SSN)。颈袢神经表现为颈总动脉及颈内静脉表面的细条状低回声带,其中71侧位于OM上腹的外下方或深处,23侧位于SCM与颈内静脉之间,26侧超声未能识别。多数(102/120,85.00%) OM下腹深处可见SSN及LTN,SSN表现为条状低回声带,OM下腹与SSN平行走行并穿过肩胛上切迹。结论 OM中间腱超声形态多为显著型,其伴行神经包括位于OM深处的颈袢、迷走神经、膈神经、臂丛、SSN及LTN,超声表现各异。

Ultrasonic manifestations of omohyoid muscle and the accompanying nerves

Objective To observe the ultrasonic manifestations of omohyoid muscle (OM) and the accompanying nerves. Methods Totally 60 healthy adults including 120 sides of shoulders and neck were prospectively enrolled. Bilateral OM and the accompanying nerves were examined with ultrasound, and the ultrasonic manifestations were observed. Results Ultrasonic images showed most OM intermediate tendons located in the depth of middle and posterior areas of sternocleidomastoid muscle (SCM), in 83 sides present as significant type, i.e. banded strong echo, while in 37 sides as non significant type, i.e. banded low echo with around hyperechoic aponeurosis. Many hypoechoic nerves, including cervical ansa, vagus nerve, phrenic nerve, brachial plexus, long thoracic nerve (LTN) and suprascapular nerve (SSN)located around OM. Ansa cervicalis manifested as thin strip low echo on the surface of carotid artery and internal jugular vein, located at the outer lower or under OM upper belly in 71 sides, between SCM and internal jugular vein in 23 sides, whereas not been recognized with ultrasound in 26 sides. Most (102/120, 85.00%) SSN presented as strip low echo and LTN were found under OM lower belly, SSN and OM lower belly ran parallel and pass through the suprascapular notch. Conclusion Most OM intermediate tendons present as significant type on ultrasonography, accompanied by cervical ansa, vagus nerve, phrenic nerve, brachial plexus, SSN and LTN with different performances located under OM.