【摘要】：目的探討兒童朗格罕細(xì)胞組織細(xì)胞增生癥(LCH)肝臟損傷的MRI表現(xiàn)及診斷價(jià)值。方法回顧性分析10例經(jīng)病理證實(shí)的兒童LCH肝臟損傷患兒的臨床及MRI資料,10例均行MRI平掃加增強(qiáng),7例行磁共振胰膽管成像(MRCP)檢查。結(jié)果 (1)常規(guī)MRI表現(xiàn):肝右葉局灶性病變1例,肝門匯管區(qū)受累1例,肝門匯管區(qū)合并肝葉受累8例,其中合并肝左葉受累2例,全肝彌漫性受累5例,肝門淋巴結(jié)腫大8例。肝門匯管區(qū)異常信號(hào)8例,表現(xiàn)為軸位上與門靜脈伴行條狀長(zhǎng)T1、長(zhǎng)T2信號(hào)5例,合并結(jié)節(jié)狀短T1脂肪信號(hào)3例;肝實(shí)質(zhì)內(nèi)片狀長(zhǎng)T1、長(zhǎng)T2信號(hào)3例,多發(fā)結(jié)節(jié)狀長(zhǎng)T1、長(zhǎng)T2信號(hào)5例,囊狀信號(hào)2例,擴(kuò)散加權(quán)成像(DWI)序列病變高信號(hào)6例。增強(qiáng)后病變不強(qiáng)化2例,環(huán)狀強(qiáng)化5例,片絮狀強(qiáng)化3例。(2)MRCP表現(xiàn):累及肝總管及右肝管2例,膽總管及肝總管2例,肝總管及左、右肝管1例,左、右肝管2例,繼發(fā)遠(yuǎn)端膽管擴(kuò)張6例。(3)MRI分級(jí):Ⅰ級(jí)1例,Ⅱ級(jí)1例,Ⅲ級(jí)3例,Ⅳ級(jí)5例。結(jié)論兒童LCH肝臟損傷具有相對(duì)特征性MRI表現(xiàn),正確認(rèn)識(shí)其特點(diǎn)可以為臨床治療方案的選擇提供重要依據(jù)。
[Abstract]:Objective to investigate the MRI findings and diagnostic value of (LCH) liver injury in children with Langerhans cell histiocytosis. Methods the clinical and MRI data of 10 children with LCH liver injury confirmed by pathology were retrospectively analyzed. MRI plain scan and enhancement were performed in 10 cases and (MRCP) examination on Mr cholangiopancreatography was performed in 7 cases. Results (1) conventional MRI findings included 1 case of focal lesions in the right lobe of the liver, 1 case of hepatic portal junction area, 8 cases of hepatic portal area with hepatic lobe involvement, including 2 cases with hepatic Zuo Ye involvement, 5 cases with diffuse hepatic involvement and 8 cases with hilar lymph node enlargement. Abnormal signal intensity in portal area of liver was found in 8 cases, showing long T 1, long T 2 signal in 5 cases and nodular short T 1 fat signal in 3 cases, flake long T 1 and long T 2 signal intensity in 3 cases of hepatic parenchyma, long T 1, long T 2 signal intensity in 3 cases of hepatic parenchyma, long T 1, long T 2 signal intensity in 3 cases. Multiple nodular long T 1, long T 2 signal in 5 cases, cystic signal in 2 cases, and high signal intensity in 6 cases on diffusion-weighted (DWI) sequence. (2) MRCP findings included common hepatic duct and right hepatic duct in 2 cases, common bile duct and common hepatic duct in 2 cases, common hepatic duct and left and right hepatic duct in 1 case, left and right hepatic duct in 2 cases, and left and right hepatic duct in 2 cases. (3) MRI classification: 1 case of grade 鈪，

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