36例朗格罕氏细胞组织细胞增生症的放射性核素骨显像特征  

The characteristic findings of radionuclide bone imaging in 36 patients with langerhans cell histiocytosis

作　　者：申超[1] 吕宽[1] 吴志兴[1] 

机构地区：[1]山东大学附属省立医院核医学科,山东济南250021

出　　处：《医学影像学杂志》2010年第12期1868-187l,共4页Journal of Medical Imaging

摘　　要：目的:探讨朗格罕氏细胞组织细胞增生症(LCH)的放射性核素骨显像特征。方法:回顾性分析了36例LCH患者全身骨显像结果,其中14例患者行颅骨SPECT断层显像。结果:36例LCH患者全身骨显像阳性30例,阳性率83.3%。其中单发病灶者14例,多发病灶者16例。颅骨阳性者14例,以顶骨和颞骨最常受累,其中4例颞骨病灶由SPECT骨断层显像检出;脊柱阳性者7例,主要见于胸椎和腰椎;四肢长骨阳性者6例,受累的部位依次为股骨、肱骨和胫骨,主要累及骨干部;肋骨阳性者2例,髂骨1例。颅骨、脊柱和四肢长骨是LCH最常累及的部位。结论:LCH在放射性核素全身骨显像中有一定的特征表现,SPECT骨断层显像能提高LCH病灶检出的阳性率,二者的联合应用在LCH的诊疗中具有较大的优势。Objective:To explore the characteristic findings of radionuclide bone imaging in patients with LCH.Methods:To retrospectively analyze the findings of whole body bone imaging in 36 patients with LCH,among which SPECT skull tomographic imaging was performed respectively in 14 cases.Results:30 of 36 cases(83.3%) had the positive findings in their whole body bone scans,with 14 cases having solitary bone lesion,16 cases having multiple bone lesion.14 cases had skull involvement which was mostly seen in the parietal bone and the temporal bone,with 4 temporal bone lesions were detected by skull SPECT;7 cases had vertebrae column involvement which mainly lied in the thoracic vertebra and lumbar vertebra;6 cases had long bone lesion with the femur,humerus,and tibia mostly involved,and the lesions mainly lied in the diaphysis;The rib and ilium involvement were respectively 2 cases and 1 case.Skull,vertebrae column and long bone were the common sites of bone involvement of LCH.Conclusion:Some characteristic findings were detected by whole body bone scan in patients with LCH,and SPECT could raise the positive rate of skeletal involvement detection of LCH.The united application of the both could play a great role in the diagnosis and therapy of LCH.

关 键 词：朗格罕氏细胞 组织细胞增生症 放射性核素 显像特征 langerhans cell histiocytosis 核素全身骨显像 阳性率 骨断层显像 四肢长骨 单发病灶 SPECT 颅骨 患者 回顾性分析 显像结果 特征表现 颞骨 联合应用 脊柱 骨病灶 

分 类 号：R8[医药卫生—临床医学] R445