摘要
目的探讨成年人骨骼朗格汉斯细胞组织细胞增生症(LCH)的影像学表现。方法回顾性分析2008年1月至2019年6月浙江省乐清市第六人民医院(3例)、浙江省乐清市第三人民医院(7例)和浙江省温州市人民医院(15例)共25例成年LCH患者的DR、CT和MRI表现。结果25例患者中,病变位于颅骨5例,脊柱5例,长骨10例,其他扁骨3例,多骨性2例。17例行DR检查,骨质呈囊状破坏11例(伴膨胀性改变6例),溶骨性破坏6例;周围骨皮质增厚5例,骨破坏内缘欠光整4例,病灶周围见软组织包块12例;"洞套洞征"2例,"扁平椎"2例,"纽扣样死骨"1例。15例行CT检查,骨质呈囊状破坏9例(伴膨胀性改变5例),溶骨性破坏6例;"洞套洞征"2例,"扁平椎"2例,"纽扣样死骨"1例。14例行MRI检查,骨质呈囊状破坏9例(伴轻度膨胀改变5例),溶骨性破坏5例;骨质破坏区T1WI呈低信号,T2WI高信号8例,T1WI呈等信号,T2WI高等混杂信号4例,T1WI呈稍高信号,T2WI高等混杂信号2例;STIR压脂序列呈高信号11例,等信号3例;DWI呈高信号。结论成年人LCH影像学表现具有一定特征性,根据影像学表现并结合临床可提高诊断准确率。
Objective To investigate the imaging features of adult bones Langerhans cell histiocytosis(LCH).Methods The DR,CT,and MRI findings of 25 adults patients with LCH from January 2008 to June 2019 in Yueqing Sixth People′s Hospital of Zhejiang Province(3 cases),Yueqing Third People′s Hospital of Zhejiang Province(7 cases)and Wenzhou People′s Hospital of Zhejiang Province(15 cases)were retrospectively analyzed.Results Among the 25 patients,the lesions located in the skull in 5 cases,in the spine in 5 cases,in the long bones in 10 cases,in the other flat bones in 3 cases,and in multiple bones in 2 cases.DR features(17 cases)showed:cystic destruction in 11 cases(6 cases with dilated changes),osteolytic damage in 6 cases;peripheral bone cortex thickening in 5 cases,bone lesions with less smooth inner edge in 4 cases,soft tissue mass around the lesion in 12 cases;'hole set cave sign'in 2 cases,'flat vertebra'in 2 cases,and'button-like dead bone'in 1 case.CT features(15 cases)showed:cystic destruction in 9 cases(5 cases with dilated changes),osteolytic damage in 6 cases;'hole set cave sign'in 2 cases,'flat vertebra'in 2 cases,and'button-like dead bone'in 1 case.MRI features(14 cases)showed:cystic destruction in 9 cases(5 cases with dilated changes),osteolytic damage in 5 cases;in the bone destruction area,8 cases had low T1WI signal and high T2WI signal,4 cases had equal T1WI signal and higher mixed T2WI signal,2 cases had slightly higher T1WI signal and higher mixed T2WI signal;STIR lipoprotein sequence showed high signal in 11 cases,and isointense signal in 3 cases;DWI showed high signal.Conclusions The imaging performance of adults LCH has certain characteristics,and the diagnostic accuracy can be improved according to the imaging performance and the clinic.
作者
黄乐珍
姜王妹
邱乾德
Huang Lezhen;Jiang Wangmei;Qiu Qiande(Department of Radiology,Yueqing Sixth People′s Hospital of Zhejiang Province,Zhejiang Yueqing 326503,China;Department of Radiology,Yueqing Third People′s Hospital of Zhejiang Province,Zhejiang Yueqing 325604,China;Department of Radiology,Wenzhou People′s Hospital of Zhejiang Province,Zhejiang Wenzhou 325000,China)
出处
《中国医师进修杂志》
2020年第1期61-65,共5页
Chinese Journal of Postgraduates of Medicine
