脊柱郎格汉斯细胞组织细胞增生症的影像表现及鉴别诊断

The imaging manifestation and differentiation diagnosis of Langerhans cell histiocytosis(LCH) of the spine

目的:探讨脊柱郎格汉斯细胞组织细胞增生症的影像学表现,进一步提高对本病的诊断水平。方法:回顾性分析43例经病理证实的脊柱嗜酸性肉芽肿的X线、CT和MRI表现。结果:35例(35/43)椎体呈楔形改变或椎体变扁,24例呈囊状破坏,7例显示软组织肿块,6例椎间隙变窄。27例患者行CT检查,CT主要表现为椎体不规则破坏和椎旁软组织肿块。15例行MRI检查,显示椎体破坏、信号异常和椎旁软组织肿块,8例软组织肿块在冠状面和矢状面呈"套袖状",相邻椎间盘信号无明显改变。结论:加深对骨嗜酸性肉芽肿病程及影像学表现的认识,能提高对该病的诊断水平,但正确诊断有赖于临床、病理和影像表现相结合。

Objective： To study the imaging features of the spine Langerhans cell histiocytosis （LCH） so as to further improve diagnosis accuracy of the disease. Methods： X ray,CT and MRI findings of 43 patients with spinal LCH confirmed by pathology were retrospectively reviewed. Results： Thirty five lesions demonstrated wedged or flattened vertebra,24 lesions with cystic bony destruction,7 patients had perivertebral soft tissue masses and 6 patients had intervertebral space narrowing. CT scan were performed in 27 patients,showing irregular bony destruction with soft tissue masses. MRI were performed in 15 patients,showing irregular bony destruction with abnormal signal intensities and perivertebral soft tissue masses. Sleeve sign were showed in 8 patients in coronal and sagittal images. No obvious change of signal intensity was displayed in adjacent intervertebral discs. Conclusion：Further understanding of imaging findings of LCH of the spine can further improve the diagnosis accuracy of the disease,yet accurate diagnosis still depends on the combination of clinical signs and symptoms ,pathology and imaging features.