脊柱多发郎格汉斯细胞组织细胞增多症的CT、MRI征象分析

发布时间：2018-01-20 06:46

本文关键词： 郎格汉斯细胞组织细胞增多症脊柱体层摄影术 X线计算机磁共振成像　出处：《中国医学影像技术》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨脊柱多发郎格汉斯细胞组织细胞增多症(LCH)的CT、MRI征象。方法回顾性分析13例经病理证实的脊柱多发LCH患者的影像学检查资料,13例均接受CT检查(1例增强扫描),其中12例接受MR检查(6例增强扫描)。结果 13例中,单中心病变8例,多中心病变5例。共34个病变脊椎,其中核心病变脊椎19个,邻近侵犯脊椎15个。18个(18/19,94.74%)核心病变脊椎存在不同形态、程度的压缩骨折。13例患者共34个病变脊椎CT均表现为溶骨性骨质破坏;19个核心病变脊椎中,18个(18/19,94.74%)骨皮质不完整、可见椎旁软组织肿块。MRI显示12例患者共33个病变脊椎,包括核心病变脊椎18个,邻近侵犯脊椎15个,T1WI均呈等、稍低或低信号,T2WI呈稍高或高信号,脂肪抑制序列呈高信号;17个(17/18,94.44%)核心病变脊椎有椎旁软组织肿块。结论脊柱多发LCH的CT、MRI表现具有一定特征性,加深对本病影像表现的认识可提高诊断和鉴别水平,但确诊需依靠病理检查。
[Abstract]:Objective to investigate the CT MRI features of multiple Langerhans cell histiocytosis (LCH) in the spine. Methods the imaging findings of 13 patients with multiple spinal LCH confirmed by pathology were retrospectively analyzed. All the 13 cases received CT scan and 1 case underwent enhanced scan, 12 cases received Mr examination and 6 cases underwent enhanced scan. Results in 13 cases, 8 cases had single center lesion. There were 34 spinal lesions in 5 patients with polycentric lesions, including 19 with core lesions, 15 with adjacent spinal involvement, and 18 with 18 / 18 / 19 (94. 74) different forms of spinal lesions. Degree of compression fracture. 13 patients with 34 lesions of spinal CT showed osteolytic bone destruction; Of the 19 core spinal lesions, 18 / 18 / 19 / 94. 74) the cortical bone was incomplete. A soft tissue mass around the vertebrae. MRI showed a total of 33 spinal lesions in 12 patients. There were 18 vertebrae with core lesions, all of them were isotropic on T _ 1WI, slightly low or low signal intensity on T _ 2WI, and hyperintense on fat suppression sequence. There were 17 / 17 / 1894. 44 core lesions in the spinal cord. Conclusion CT MRI findings of multiple spinal LCH have certain characteristics. Further understanding of the imaging manifestations of the disease can improve the diagnosis and differential level, but the diagnosis depends on pathological examination.
【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】：R681;R816.8;R445.2
【正文快照】： 发生于骨骼的郎格汉斯细胞组织细胞增多症(Langerhans cell histiocytosis,LCH)在2013年WHO骨肿瘤分类中分为未明确性质肿瘤中的中间型(局部侵袭性),发生于脊柱者少见,仅占约6.5%~25.0%[1-2],且患者多为单发。本研究探讨脊柱多发LCH的CT、MRI特征,旨在提高对本病的诊断和鉴别

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