本文選題：脊柱 + 成年人　； 參考：《中國醫(yī)學(xué)影像技術(shù)》2017年09期

【摘要】：目的探討成人脊柱朗格漢斯組織細(xì)胞增生癥(LCH)的影像學(xué)表現(xiàn)。方法對29例成人脊柱LCH的影像表現(xiàn)進行分析,評估病變數(shù)目、部位、骨破壞形式、椎旁及椎管內(nèi)情況、MRI信號及增強特點。結(jié)果 29例患者脊柱病變48處,其中頸椎26處、胸椎17處、腰骶椎5處;11例累及脊柱多節(jié)段。骨破壞累及椎體15例(15/29,51.72%),椎體和附件均累及14例(14/29,48.28%);34.48%(10/29)伴硬化邊,13.79%(4/29)伴鄰近骨硬化;75.86%(22/29)病變突破骨皮質(zhì);48.28%(14/29)合并椎體壓縮,其中7例(7/29,24.13%)表現(xiàn)為扁平椎。T2WI呈等或低信號占57.89%(11/19),高信號占31.58%(6/19),混雜信號占10.53%(2/19);增強掃描94.12%(16/17)呈明顯強化,5.88%(1/17)呈輕度強化。結(jié)論成人LCH好發(fā)于頸椎;骨破壞以椎體為主;可累及多個脊柱節(jié)段、呈連續(xù)或跳躍分布,扁平椎不少見、骨破壞周圍的骨硬化對提示診斷有一定幫助。
[Abstract]:Objective to investigate the imaging findings of adult LCHs with Langerhans histiocytosis. Methods the imaging findings of 29 adult patients with spinal LCH were analyzed to evaluate the number of lesions, location, bone destruction, vertebral collateral and spinal canal. Results there were 48 spinal lesions in 29 patients, including 26 cervical vertebrae, 17 thoracic vertebrae and 5 lumbosacral vertebrae. There were 15 cases of bone destruction involving the vertebral body, 15 / 29 / 51.72%, 14 cases of vertebral body and appendages involving 14 / 14 / 29 and 48.28% ~ 34.48% 10 / 29) with sclerosing side, 13.79% 42 / 29) with adjacent bone sclerosis (75.86% 22 / 29) and 48.28% 14 / 29) with compression of the vertebral body. Among them, 7 cases showed flat vertebrae with equal or low signal intensity on T 2WI (57.89%), high signal intensity (31.58% / 19%), mixed signal intensity (10.53% / 19%), enhanced scanning (94.12% 16 / 17), obvious enhancement (5.88 1 / 17) and slight enhancement. Conclusion Adult LCH is more common in cervical vertebrae, bone destruction mainly occurs in vertebrae, multiple segments of spine can be involved, and flattened vertebrae is not uncommon. Bone sclerosis around bone destruction is helpful for diagnosis.
【作者單位】： 北京大學(xué)第三醫(yī)院放射科;北京大學(xué)第三醫(yī)院骨科;
【分類號】：R445.2;R681.5

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本文編號：1920466