超声诊断儿童朗格汉斯组织细胞增生症颅骨病变的价值

Value of ultrasonography in the diagnosis of skull lesions of Langerhans cell histiocytosis in children

目的本研究旨在分析超声诊断颅骨朗格汉斯组织细胞增生症的声像图特征。方法回顾性分析经病理证实的19例颅骨朗格汉斯组织细胞增生症患儿的超声表现,总结其声像图特征,并与CT、MRI的特征进行比较。结果19例患儿共发现颅骨病变25个部位,4例为颅骨多发病变。其中颞部12个,顶部7个,枕部5个,颊部1个。超声表现为颅骨膨胀性破坏,颅骨内外板分离呈斜坡状或呈阶梯形,破坏的骨质边缘锐利,形态不规则。所有病变同时伴有软组织低回声肿块,2例伴有无回声区。肿块内可见丰富的短棒状血流信号。CT和MRI结果:19例行CT检查,4例行MRI检查,表现为局部骨质破坏伴软组织肿块。CT发现胸椎椎体病变1例。结论颅骨朗格汉斯组织细胞增生症的超声表现具有一定的特征性。超声因其具有不具放射性、方便及经济的优点,可以作为颅骨朗格汉斯组织细胞增生症的首选检查方法。

Objective To explore the features and value of ultrasonography in diagnosing skull lesions of Langerhans cell histiocytosis in children.Methods The ultrasonographic findings of 19 cases of skull lesions of Langerhans cell histiocytosis were analyzed retrospectively.The ultrasonographic features were summarized and compared with the findings of computed tomography(CT)and magnetic resonance imaging(MRI).Results Twenty-five lesions in 19 cases were revealed by ultrasound.Four cases had multiple lesions.The sites were temporal(n=12),parietal(n=7),occipital(n=5)and buccal(n=1);Ultrasound revealed skull lesions involving inner and outer tables with sharp edge and irregular shape.The edge was ladder-like.Bone pieces could be visualized in 3 lesions.All lesions were accompanied by hypoechoic soft tissue mass and two had an echoless zone.Abundant blood flow signal could be visualized in masses;CT&MRI:19 cases underwent CT examination while 4 cases received MRI examination.Skull lesions were detected with soft tissue masses.One horacic lesion was detected by CT.Conclusion The skull lesions of Langerhans cell histiocytosis had characteristic ultrasonographic features.Ultrasonography may be helpful and preferred for initial evaluations of suspected skull lesions of Langerhans cell histiocytosis as it is non-invasive,radiation-free and inexpensive.