儿童郎罕细胞组织细胞增生症骨骼病变的影像学诊断(附35例)  

Imaging Diagnosis of the Skeletal Lesions in Children Langerhans Cell Histiocytosis(A Report of 35 Cases)

作　　者：王秋艳[1] 李玉华[1] 朱杰明[1] 

机构地区：[1]上海第二医科大学附属新华医院放射科

出　　处：《实用放射学杂志》1998年第3期134-137,共4页Journal of Practical Radiology

摘　　要：目的：分析儿童郎罕细胞组织细胞增生症骨骼病变的影像学表现和特点，阐述其在本症临床诊断中作用。方法：搜集了经病理证实的儿童郎罕细胞组织细胞增生症３５例。其中男性２１例，女性１４例。年龄８个月～１０岁，平均３．７５岁。除Ｘ线平片外，１８例还进行了ＣＴ扫描，其中单纯平扫１０例，平扫加增强８例。结果：本组中颅骨破坏２１例，占６０％。脊柱５例，占１４．３％。长骨１３例，占３４．４％。扁平骨和不规则骨１５例，占４２％。勒一雪病、韩一雪一柯综合症及中间型以颅骨破坏为主，而嗜酸性肉芽肿则以长骨和脊柱为主。结论：本症的骨骼病变在Ｘ线影像学上有较特殊的表现，是临床诊断和鉴别诊断的重要手段，有时甚至可起到决定性的作用，此外还能观察疗效，了解有无复发等。Objective:To analyse the imaging features of the skeletal lesions in children with langerhans cell histiocytosis.To explain imagiologs significance in clinical diagnosis.Methods:35 cases of children langerhans cell histiocytosis proved by pathology were collected.There were 21 males and 14 females,ranged in from 8 months to 10 years(mean 3.75 years).All patients had X-ray plain films.18 cases were examed by CT and 8 of which were included skull underwent enhanced scans. Results:Among 35 cases,the bone destruction 21 cases(60%),vertebra column 5 cases(14.3%),long tubeshaped bones 12 cases(34%),platybones and irregular bones 15 cases(42%).Letter-Siwes diseases,Hand-Schuller-Christians syndrom and intermediary type mainly involved skull bones,while eosinopilic granulomas mainly involoed long tube-shaped bones.Conclusion:The characteristic X-ray features of skeletal lesons in this disease take a great role in clinical diagnosis and differencial diagnosis,furthmore they are very important in observing therapeutic effect and recurrence of disease.

关 键 词：郎罕细胞 组织细胞增生 X线摄影 骨骼病变 

分 类 号：R733.04[医药卫生—肿瘤] R730.44[医药卫生—临床医学]