成人脊柱朗格汉斯组织细胞增生症的影像学表现

发布时间：2018-05-21 19:33

本文选题：脊柱 + 成年人　；参考：《中国医学影像技术》2017年09期

【摘要】：目的探讨成人脊柱朗格汉斯组织细胞增生症(LCH)的影像学表现。方法对29例成人脊柱LCH的影像表现进行分析,评估病变数目、部位、骨破坏形式、椎旁及椎管内情况、MRI信号及增强特点。结果 29例患者脊柱病变48处,其中颈椎26处、胸椎17处、腰骶椎5处;11例累及脊柱多节段。骨破坏累及椎体15例(15/29,51.72%),椎体和附件均累及14例(14/29,48.28%);34.48%(10/29)伴硬化边,13.79%(4/29)伴邻近骨硬化;75.86%(22/29)病变突破骨皮质;48.28%(14/29)合并椎体压缩,其中7例(7/29,24.13%)表现为扁平椎。T2WI呈等或低信号占57.89%(11/19),高信号占31.58%(6/19),混杂信号占10.53%(2/19);增强扫描94.12%(16/17)呈明显强化,5.88%(1/17)呈轻度强化。结论成人LCH好发于颈椎;骨破坏以椎体为主;可累及多个脊柱节段、呈连续或跳跃分布,扁平椎不少见、骨破坏周围的骨硬化对提示诊断有一定帮助。
[Abstract]:Objective to investigate the imaging findings of adult LCHs with Langerhans histiocytosis. Methods the imaging findings of 29 adult patients with spinal LCH were analyzed to evaluate the number of lesions, location, bone destruction, vertebral collateral and spinal canal. Results there were 48 spinal lesions in 29 patients, including 26 cervical vertebrae, 17 thoracic vertebrae and 5 lumbosacral vertebrae. There were 15 cases of bone destruction involving the vertebral body, 15 / 29 / 51.72%, 14 cases of vertebral body and appendages involving 14 / 14 / 29 and 48.28% ~ 34.48% 10 / 29) with sclerosing side, 13.79% 42 / 29) with adjacent bone sclerosis (75.86% 22 / 29) and 48.28% 14 / 29) with compression of the vertebral body. Among them, 7 cases showed flat vertebrae with equal or low signal intensity on T 2WI (57.89%), high signal intensity (31.58% / 19%), mixed signal intensity (10.53% / 19%), enhanced scanning (94.12% 16 / 17), obvious enhancement (5.88 1 / 17) and slight enhancement. Conclusion Adult LCH is more common in cervical vertebrae, bone destruction mainly occurs in vertebrae, multiple segments of spine can be involved, and flattened vertebrae is not uncommon. Bone sclerosis around bone destruction is helpful for diagnosis.
【作者单位】：北京大学第三医院放射科;北京大学第三医院骨科;
【分类号】：R445.2;R681.5

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