儿童幼年性黄色肉芽肿的影像学表现  

Imaging Features of Juvenile Xanthogranuloma in Children

作　　者：马秋红 尹一伟 何四平 向永华 金科 MA Qiuhong;YIN Yiwei;HE Siping;XIANG Yonghua;JIN Ke(Department of Radiology,the Affiliated Children's Hospital of Xiangya School of Medicine,Central South University(Hunan Children's Hospital),Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院)放射科,湖南长沙410007

出　　处：《中国医学影像学杂志》2024年第12期1222-1227,1230,共7页Chinese Journal of Medical Imaging

基　　金：湖南省卫生健康委卫生科研课题(202209012935)。

摘　　要：目的 分析儿童幼年性黄色肉芽肿(JXG)的影像学表现,提高对此病的诊断水平。资料与方法 回顾性分析湖南省儿童医院2011年1月—2023年12月经活检或手术病理证实的15例JXG患儿的临床及影像资料,13例行CT检查,7例行MRI检查,5例行MRI和CT检查。观察分析JXG的分型、数目、累及部位、病变信号、密度及强化特征等征象。结果 15例JXG患儿中,系统型黄色肉芽肿7例,其中累及中枢神经系统5例(分别为松果体区、脉络丛、颅骨内板下硬脑膜、中颅窝及椎管)、乳突1例、肝脏3例、肾脏3例、胰腺1例、肺部2例,主要表现为不同器官单发或多发结节状、团块状或斑片状病变。MRI上病变表现为T1WI呈稍高/稍低/混杂信号,T2WI呈低/稍低/稍高/混杂信号,弥散未受限或受限,增强呈明显强化或稍强化。CT上病变表现为斑片状、团块状或结节状低密度/高密度影,增强呈轻中度不均匀强化或明显强化。皮肤型黄色肉芽肿8例,表现为皮下软组织结节状影,T1WI呈等或稍低信号,T2WI呈稍低或低信号,明显强化;CT表现为稍低/等/稍高密度影,增强呈稍强化/明显强化。结论 JXG主要表现为皮下软组织和(或)各脏器单发/多发结节状、团块状影,T1WI上信号增高,T2WI上信号减低,弥散减低或增高,明显强化,其CT及MRI表现具有一定的特征。Purpose To analyze the imaging features of juvenile xanthogranuloma(JXG)in children and to improve the diagnostic level of JXG.Materials and Methods The clinical and imaging data of 15 children with JXG confirmed by menstrual biopsy or surgical pathology from January 2011 to December 2023 in Hunan Children's Hospital were retrospectively analyzed.13 cases underwent CT examinations and 7 cases underwent MRI examinations,of which 5 underwent both MRI and CT examinations.The type,number,involved site,lesion signal,density and enhancement characteristics of JXG were observed and analyzed.Results Of the 15 children with JXG,7 cases were systemic.It involves the central nervous system(5 cases,including pineal region,choroid plexus,cranial sublamina,middle cranial fossa and spinal canal),mastoid process(1 case),liver(3 cases),kidney(3 cases),pancreas(1 case)and lung(2 cases),mainly manifested as single or multiple nodular,mass or patchy lesions in different organs.On MRI,the lesions showed slightly higher or lower or mixed signals on T1WI,low/slightly lower or higher or mixed signals on T2WI,unrestricted or limited diffusion,and significantly enhanced or slightly enhanced enhancement.On CT,the lesions showed patchy,clumpy or nodular low-density or high-density shadows,and the enhancement was mild to moderate uneven enhancement or obvious enhancement.8 patients with simple skin type showed nodular shadow of subcutaneous soft tissue,equal or slightly low signal on T1WI,slightly low/low signal on T2WI and obvious enhancement.CT showed a slightly low/equal/slightly high density image,and the enhancement showed a slightly enhanced/significantly enhanced image.Conclusion JXG mainly presents as single or multiple nodules and clumps in subcutaneous soft tissues and/or various organs,with increased signal on T1WI,decreased signal on T2WI,decreased or increased diffusion and obvious enhancement.The CT and MRI manifestations of JXG have certain characteristics.

关 键 词：黄肉芽肿 青少年性 儿童 体层摄影术 X线计算机 磁共振成像 

分 类 号：R551[医药卫生—血液循环系统疾病] R445.2[医药卫生—内科学] R445.3[医药卫生—临床医学]