儿童颞骨郎格罕细胞组织细胞增生症的CT诊断与鉴别诊断  

CT diagnosis of temporal bone Langerhans cell histiocytosis in children

作　　者：贺中云 田强 韦霞俊 朱利 

机构地区：[1]株洲市331医院放射科,湖南412002 [2]株洲市331医院病理科,湖南412002

出　　处：《影像诊断与介入放射学》2012年第1期7-10,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的总结7例儿童颞骨郎格罕组织细胞增生症(LCH)的CT影像特点,提高CT诊断准确性。方法回顾性分析我院2005年3月～2011年5月期间经手术病理证实的儿童颞骨LCH 7例,术前均行颞骨螺旋CT轴位薄层平扫(层厚2～3 mm),3例行增强扫描,分析其CT表现。结果 5例为颞骨单发病灶,2例颅骨有多发病灶;5例CT表现为颞骨乳突部的溶骨性骨质破坏,2例颞骨乳突部及颞骨鳞部的骨质破坏,1例听小骨骨质破坏,7例颞骨骨质破坏区均见软组织肿块形成,软组织肿块突入外耳道,3例侵入左侧中颅窝,2例侵入后颅窝,2例肿块侵及颞下窝,4例肿块累及鼓室及乳突窦,3例乙状窦前壁骨质破坏缺损;2例累及面神经管乳突段,1例见多发点状残留骨,7例均未见明显骨膜反应及骨质硬化。结论儿童颞骨LCH好发于颞骨乳突部,CT表现为溶骨性骨质破坏并局部软组织肿块形成,无骨质硬化及骨膜反应,软组织肿块强化明显,CT检查可以提高本病的诊断准确性。Objective To evaluate the CT features of pediatric temporal bone Langerhans cell histiocytosis （LCH）. Methods CT of 7 children pathologically confirmed with temporal bone LCH between March 2005 and May 2011 was retrospectively analyzed. Axial unenhanced temporal bone CT scan with 2-3 mm slice thickness was performed in all patients and contrast-enhanced scans were also acquired in 3 children. The CT features were reviewed. Restdts The temporal bone lesions were solitary in 5 patients and multiple skull lesions were found in 2 cases. CT showed bone de- struction involving the mastoid （5 patients）, temporal bone squama （2）, and middle ear ossicles （1）. Soft tissue mass- es were noted on all 7 patients with tumor extension into the external auditory canal （7）, invasions of left middle cra- nial fossa （3）, posterior fossa （2）, temporal fossa （2）, middle ear and mastoid air cells （4）, sigmoid sinus groove; mastoid segment of facial nerve canal （2）. Multiple small residual bone fragments were noted in＇ one patient. No pe- riosteal reaction or bone sclerosis was found in any of the 7 patients. Conclusion Pediatric temporal bone LCH origi- nates in the mastoid bone with CT features of bone destruction and enhancing soft tissue mass, no bone sclerosis or pe- riosteal reaction.

关 键 词：LANGERHANS组织细胞增生症 颞骨 体层摄影术 X线计算机 儿童 

分 类 号：R726.8[医药卫生—儿科] R816.92[医药卫生—临床医学]