小儿朗格罕斯细胞组织细胞增生症肝脏浸润的CT及MR表现  

CT and MRI of Langerhans cell histiocytosis with liver involvement in children

作　　者：薛潋滟 邵虹 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心放射科,上海200127

出　　处：《影像诊断与介入放射学》2017年第3期196-199,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨儿童朗格罕斯细胞组织细胞增生症(LCH)肝脏浸润的腹部CT、MRI的影像学特征。方法对31例经临床、实验室及病理确诊为LCH的肝脏浸润患儿的腹部CT和/或MRI结果进行回顾性分析,其中男18例,女13例;25例行腹部CT增强扫描,其中6例加做MRI检查;另6例仅行MRI扫描。结果肝脏弥漫性增大,病灶的CT表现为稍低密度影,增强后少许强化;MRI为T_1WI稍低、T_2WI稍高信号,增强后不均匀强化。按病灶形态及分布分为三型:(1)中央型(9例),汇管区沿门静脉走行的线样病灶;(2)周围型(11例),肝实质内不同数量结节影;(3)弥漫型(11例),兼有中央型和周围型的改变。结论 LCH肝脏浸润的CT和/或MRI表现有一定特点,了解这些特点有助于儿童LCH的早期诊断,为治疗争取时间。Objective To investigate the hepatic imaging appearance of Langerhans cell histiocytosis （LCH） with liver in-volvement. Methods 31 children （18 boys, 13 girls） with liver involvement of LCH confirmed by clinical, laboratory and pathologi-cal examinations were included in the study. CT without and with intravenous contrast of 25 children and MRI of 12 children were retrospectively analyzed. Results Varying degree of hepatomegaly was noted in all children. The liver lesions were hypodense with little enhancement on CT, Ti-hypointense and T2-hyperintense on MRI. The lesions could be categorized as central linear with cen-tral portal vein （9）, peripheral （11） multi-nodular, or diffuse （11） containing both linear and multi-nodular features. Conclusion The CT and MRI features of LCH with liver involvement are helpful to the early differential diagnosis and treatment of LCH in chil-dren.

关 键 词：朗格罕斯细胞组织细胞增生症 肝脏浸润 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R725.9[医药卫生—诊断学] R816.92[医药卫生—临床医学]