儿童郎格罕细胞组织细胞增生症颅内侵犯的MRI表现  

MR imaging presentation of intracranial disease associated with Langerhans cell histiocytosis in children

作　　者：郑鹤琳[1] 蔡金华[1] 

机构地区：[1]重庆医科大学附属儿童医院放射科,重庆400014

出　　处：《第三军医大学学报》2013年第22期2482-2485,共4页Journal of Third Military Medical University

摘　　要：目的探讨儿童郎格罕细胞组织细胞增生症（Langerhans cell histiocytosis, LCH）颅内侵犯的MRI表现特点。方法回顾性分析2007年12月至2013年4月我院15例经手术或穿刺活检证实的LCH，其中男性11例，女性4例，年龄1～13岁，病例均行头颅、垂体MR平扫及增强扫描，重点观察病灶部位、形态、信号表现及强化情况。结果下丘脑垂体病变10例（66.7%），表现为垂体后叶T1WI高信号消失及垂体柄增粗和强化。脑硬膜肿块2例，脉络丛肿块1例，主要表现为T1WI等或稍低信号、T2WI低信号，增强后显著强化。脑实质病变5例（其中3例合并下丘脑垂体病变），主要累及小脑齿状核及基底节，呈对称性斑片状稍长T1稍长T2信号，强化不明显。结论LCH颅内病变的部位、形态及信号表现多样，下丘脑垂体受累最为多见，T2WI低信号及增强后显著强化是LCH轴外肿块的特征。Objective To investigate the MRI manifestations of intracranial lesions associated with Langerhans cell histiocytosis （LCH） in children. Methods Fifteen cases of LCH confirmed by surgery pathology or puncture biopsy were reviewed. Eleven patients were males, and 4 females, with age ranged from 1 to 13 years old. Plain and contrast enhanced MR imaging of head and pituitary were performed in all patients. The location, morphology, signal and enhanced patterns of the intracranial lesions were observed and analyzed. Results The most common intracranial finding was the hypothalamic-pituitary involvement which was demonstrated in 10 patients （66.7%）, including absence of normally high signal on T1WI in the posterior pituitary gland and thickening and abnormal contrast enhancement of the pituitary stalk. Dural mass was detected in 2 cases, and choroid-plexus mass was detected in 1 case. The masses were characterized by iso- or slightly hypo-intensity on T1WI and hypo-intensity on T2WI, with marked enhancement after administration of gadolinium. Brain parenchymal lesions were detected in 5 cases, in which 3 accompanied with hypothalamic-pituitary lesions. The parenchymal lesions mainly involved the cerebellar dentate nucleus and basal ganglia, and showed symmetrically patchy hypo-intensity on T1WI and hyper-intensity on T2WI, with no contrast enhancement. Conclusion The intracranial lesions of LCH varies in region, morphology and signal patterns. The hypothalamic-pituitary involvement is more commonly encountered. Hypo-intensity on T2WI and marked enhancement are MRI features of extra-axial mass of LCH.

关 键 词：郎格罕细胞组织细胞增生症 中枢神经系统 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R725.511[医药卫生—诊断学]