全身骨显像在婴幼儿朗格汉斯组织细胞增多症诊断和分期中的应用

Application of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis in infants

目的探讨全身骨显像在婴幼儿朗格汉斯组织细胞增多症(LCH)诊断和分期中的应用价值。方法对20例经手术病理或骨髓穿刺、皮疹压片细胞学确诊为LCH的婴幼儿行全身骨显像检查,对骨显像阳性者加行局部X线或CT检查。利用ROI技术计算全身骨显像阳性病灶的F/N比值并求出位于相同部位病灶的F/N比值均值。结果 20例患儿全身骨显像10例阳性,4例为多发病灶,6例为单发病灶。单纯颅骨放射分布异常3例,颅骨合并其他部位骨3例,肩胛骨2例,肋骨1例,下肢骨1例;单发颅骨病灶的F/N比值均值为0.36,长骨病灶的F/N比值均值为3.52。结论全身骨显像有助于婴幼儿LCH的诊断及分期。

Objective To assess the application value of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis（LCH） in infants.Methods Whole-body bone scintigraphy was performed in 20 infants of LCH confirmed with surgical pathology or bone marrow aspiration and laboratory data.The infants with positive bone scintigraphy underwent X-ray or CT,and the F/N value of positive lesions and lesions located in the same area were calculated by ROI technology.Results Ten of 20 patients showed positive in bone scans,including 4 with multi-focal lesions and 6 with single lesion.Among 10 patients with positive scintigrams,there were 3 patients with abnormal bone uptakes limited to cranial,3 with cranial and other parts of abnormal bone uptakes,2 with scapula abnormal uptakes,as well as rib and lower limb bone involvement（each n=1）.The average ratios of F/N on cranial alone was 0.36,while focused on long bones was 3.52.Conclusion Whole-body bone scintigraphy is useful in the diagnosis and staging of LCH in infants.