儿童Langerhans细胞组织细胞增生症中放射性核素骨显像的临床应用价值

Clinical value of radionuclide bone imaging in children with Langerhans' cell histiocytosis

目的:探讨放射性核素骨显像在儿童Langerhans细胞组织细胞增生症中的研究价值。方法:回顾性分析了40例LCH患儿放射性核素骨显像结果,其中16例患儿进行2～4次随访显像。结果:40例LCH患儿骨显像阳性33例,阳性率82.5%。其中单发病灶者15例,多发病灶者18例。颅骨阳性者15例,以顶骨和颞骨最常受累;四肢长骨阳性者7例,受累的部位依次为股骨、肱骨和胫骨,主要累及骨干部;脊柱阳性者8例,肋骨阳性者2例,髂骨1例。16例随访显像除1例无明显改善,1例缓解后又复发外,14例显像浓聚程度明显减轻。结论:放射性核素骨显像在儿童Langer-hans细胞组织细胞增生症中的诊疗和随访价值较大,有利于评估疗效。

OBJECTIVE：To detect the value of radionuclide bone imaging in children with Langerhans＇ cell histiocytosis.METHODS：To retrospectively analyze the findings of radionuclide bone imaging in 40 children with LCH,among which 2-4 follow-up whole body bone scans were performed in 16 cases.RESULTS：33 of 40 cases （82.5%） had the positive findings in their bone scan,with 15 cases having solitary bone lesion,and 18 cases having multiple bone lesion.Skull lesion was found in 15 cases,with the parietal bone and temporal bone mostly involved.Long bone lesions which mainly lied in the diaphysis were found in 7 cases,with the femur,humerus and tibia mostly involved.The involvement of vertebrae column,rib and ilium was respectively 8 cases,2 cases and 1 case.Among the follow-up bone scan,14 cases had decreased to normal accumulation of radio-activity except 1 case having constant radioactive uptake,and 1 case having recurred abnormal radioactive uptake after series of therapy.CONCLUSIONS：Radionuclide bone imaging play a important role in the diagnosis,therapy and follow-up of children with LCH.It is helpful to evaluate the efficacy of LCH.