锁骨朗格汉斯组织细胞增生症的影像诊断及鉴别  

Imaging Diagnosis and Differential Diagnosis of Clavicular Langerhans Histiocytosis

作　　者：李明球[1] 杜钢[2] 彭加友[1] 方挺松[1] 张家雄[1] LI Mingqiu;DU Gang;PENG Jiayou;FANG Tingsong;ZHANG Jiaxiong(Department of Radiology,Foshan hospital of traditional Chinese Medicine,Foshan 528000,China;Department of Radiology,Nanfang hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]佛山市中医院CT室,广东佛山528000 [2]南方医科大学南方医院放射科,广州510515

出　　处：《CT理论与应用研究（中英文）》2021年第4期533-538,共6页Computerized Tomography Theory and Applications

摘　　要：目的:总结锁骨朗格汉斯组织细胞增生症(LCH)的影像表现。材料与方法:收集2005年7月至2018年12月9例(男女比4︰5,平均年龄10.5岁)手术病理证实的锁骨LCH的术前X线、CT、MRI资料进行回顾性分析。结果:有4例位于锁骨中段,2例位于锁骨外1/3段,3例位于锁骨内1/3段或中内2/3段。6例表现为纯溶骨性骨质破坏,骨皮质断裂,破坏区边缘见反应性骨质增生及层状骨痂;1例表现为虫蚀状骨质破坏,病灶膨胀不明显,边界模糊。2例病灶膨胀性生长,其内见多发骨间隔,骨包壳完整,周围无软组织肿块。4例病灶在T1WI上呈不均匀低信号,T2WI上呈不均匀高信号,增强扫描中度不均匀强化。结论:锁骨LCH好发于儿童,不同分期和锁骨的不同部位影像表现均不同,需和尤文肉瘤、慢性骨髓炎、浆细胞骨髓瘤等疾病鉴别。Objective: To summarize the imaging findings of langerhans histiocytosis(LCH) of the clavicle. Materials and methods: Preoperative X-ray, CT and MRI data of 9 cases(male and female ratio 4:5, average age 10.5 years) of clavicular LCH confirmed by surgery and pathology from July 2005 to December 2018 were collected for retrospective analysis. Results: There were 4 cases in the middle clavicle, 2 cases in the outer 1/3 of the clavicle, and 3 cases in the inner 1/3 or middle 2/3 of the clavicle. 6 cases showed pure osteolytic bone destruction, cortical fracture, reactive hyperplasia and lamellar callus at the edge of the damaged area. One case presented with insect-etched bone destruction with indistinct distension and blurred boundary. In 2 cases, the lesions showed expansible growth with multiple bone septa, intact bone capsule and no surrounding soft tissue mass. In 4 cases, the lesions presented uneven low signal on T1 WI, uneven high signal on T2 WI, and moderate uneven enhancement on enhanced scan. Conclusion: LCH of clavicle is common in children, and the imaging manifestations of different stages and different parts of clavicle are different, which should be differentiated from ewing’s sarcoma, chronic osteomyelitis, plasma cell myeloma and other diseases.

关 键 词：组织细胞增生症 电子计算机断层扫描 锁骨 

分 类 号：R814[医药卫生—影像医学与核医学]