摘要
目的探讨多系统受累的朗格汉斯细胞组织细胞增生症(MSLCH)影像学表现及诊断价值。方法回顾性分析9例上海交大医学院附属瑞金医院确诊的多系统LCH的临床和影像学表现。结果累及骨骼5例,其中2例颅骨、1例眼眶骨病变X线或CT呈穿凿样骨质破坏,2例MRI增强颅内病灶侵犯脑膜或引起脑实质水肿。1例胸椎骨损害CT表现为扁平椎。1例双下肢长骨骨损害以骨质硬化为主要改变。下丘脑-垂体轴受累4例,MRI表现为神经垂体T1WI信号消失,受累部位增粗、明显强化。甲状腺受累2例,1例CT表现为甲状腺弥漫性增大,密度减低,轻度强化,1例彩色超声多普勒表现为低回声结节,CDFI示其内血供程度低。肺脏受累3例,HRCT表现为双肺上中肺叶形态不一的囊性病变,合并边界不清的小结节,病变不累及肋膈角区。肝脏受累1例,MRI增强检查显示肝内弥漫分布大小不一结节,均匀或环形强化。结论熟悉MSLCH影像学特点,综合实验室检查,有利于本病早期诊断,但确诊依靠病理学检查。
Objective To investigate the Imaging manifestations and values of Langerhans cell histiocytosis with multiple system referred(MSLCH).Methods Clinical data and imaging manifestations of 9 cases with pathology proved multisystem langerhans cell histiocytosis were retrospectively analyzed in Ruijin Hospital.Results Bone involvement was found in 5 cases,with 2 in skull and 1 in orbital.Perforated bone destruction was shown in X-ray or CT findings.There were 2 cases in encephalic lesions with meninges invaded or parenchymal edema on enhanced MRI.Flat vertebrae on CT was found in 1 case of thoracic vertebral bone lesion.Osteosclerosis was the main change of long bone lesion in 1 case.There were 4 cases of hypothalamic-pituitary axis involvement.T1WI signal of neurohypophysis disappearance and the involved area that became thicker and stronger were main MRI manifestations.Thyroid involvement occurred in 2 cases.CT showed diffuse enlargement,decreased density and slight enhancement in 1 case.Color Doppler ultrasound showed hypoechoic nodules in 1 case,and CDFI showed low blood supply.There were 3 cases of lung involvement.HRCT showed cystic lesions of different shapes in the upper and middle lobes of both lungs,with small nodules with unclear boundary.The lesions did not involve the costal diaphragm angle.Hepatic involvement occurred in 1 case.Enhanced MRI showed diffuse nodules of different sizes,uniform or circular enhancement.Conclusion Acquaintance of the feature of imaging examination of MSLCH combined with laboratory examination makes for early diagnosis,but the final diagnosis depends on pathological examination.
作者
李鹏
蔡莹
何继敏
唐永华
钟捷
LI Peng;CAI Ying;HE Jimin;TANG Yonghua;ZHONG Jie(Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu 610100, P.R.China;Department of Ultrasound, Longquanyi District Maternal And Child Health Hospital, Chengdu 610100, P.R.China;Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medcine, Shanghai 200000, P.R.China;Deapartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medcine, Shanghai 200000, P.R.China)
出处
《医学影像学杂志》
2020年第7期1145-1148,共4页
Journal of Medical Imaging
基金
国家自然科学基金项目(编号:81670503)。
作者简介
李鹏(1986-),男,河北定州人,毕业于川北医学院,本科学历,主治医师,主要从事放射影像诊断工作;通讯作者:唐永华,副主任医师,医学博士,E-mail:tyh10636@rjh.com.cn。
