脊柱多发LCH的CT和MRI影像学诊断与价值分析
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摘要
目的分析脊柱多发朗格汉斯细胞组织细胞增生症(LCH)的CT及磁共振(MRI)的影像学诊断价值。方法研究我院2010年1月-2018年1月间收治的12例脊柱多发LCH患者影像学资料,以病理检查为标准,分析CT与MRI在疾病中的应用价值。结果病理检查证实12例患者中,单中心病变伴邻近椎骨侵犯9例,多中心病变3例,共发现33个病变脊椎,其中核心病变脊椎20个,邻近侵犯脊椎13个;CT检查共发现33个病变脊椎,其中核心病变20个,邻近侵犯13个,CT病变检出率为100%,1例患者行增强扫描,检出1个核心病变脊椎,增强扫描呈明显不均匀强化;MRI检查共检出33个病变脊椎,其中核心病变20个,侵犯脊椎13个,MRI病变检出率为100%,7例进行增强扫描,共发现10个核心病变脊椎,其中9个增强扫描中呈明显均匀强化,1个呈明显不均匀强化。结论脊柱多发性LCH的确诊依旧以穿刺或手术等病理检查为准,MRI与CT在疾病的诊断中各有优缺点,综合分析患者影像学资料及临床特征后,才能做出正确判断。
Objective To analyze the imaging diagnostic value of CT and magnetic resonance imaging(MRI) in patients with multiple spinal Langerhans cell histiocytosis(LCH). Methods The imaging data of 12 patients with multiple spinal LCH from January2010 to January 2018 were studied. The pathological examination was used as the standard to analyze the application value of CT and MRI in the disease. Results Among 12 patients confirmed by pathological examination, 9 cases were single-center lesions with adjacent vertebrae invasion and 3 cases were multi-center lesions, and 33 vertebral lesions were found, including 20 core vertebral lesions and 13 adjacent vertebrae invasions. 33 vertebral lesions were found by CT scan, including 20 core lesions and 13 adjacent invasions, and the lesion detection rate of CT examination was 100%, and 1 case was given enhanced scan, and 1 core lesion was detected, and the enhanced scan showed no obvious uneven enhancement. 33 vertebral lesions were detected by MRI examination, including 20 core lesions and 13 vertebrae invasions, and the lesion detection rate of MRI examination was100%, and 7 cases were given enhanced scan, and a total of 10 core lesions were found,of which 9 were obvious even enhancement and 1 was obvious uneven enhancement in the enhanced scan. Conclusion The diagnosis of multiple spinal LCH is still based on pathological examinations such as puncture or surgery. MRI and CT have their own advantages and disadvantages in the diagnosis of disease. A correct judgment can be made after comprehensive analysis of imaging data and clinical features.
Objective To analyze the imaging diagnostic value of CT and magnetic resonance imaging(MRI) in patients with multiple spinal Langerhans cell histiocytosis(LCH). Methods The imaging data of 12 patients with multiple spinal LCH from January2010 to January 2018 were studied. The pathological examination was used as the standard to analyze the application value of CT and MRI in the disease. Results Among 12 patients confirmed by pathological examination, 9 cases were single-center lesions with adjacent vertebrae invasion and 3 cases were multi-center lesions, and 33 vertebral lesions were found, including 20 core vertebral lesions and 13 adjacent vertebrae invasions. 33 vertebral lesions were found by CT scan, including 20 core lesions and 13 adjacent invasions, and the lesion detection rate of CT examination was 100%, and 1 case was given enhanced scan, and 1 core lesion was detected, and the enhanced scan showed no obvious uneven enhancement. 33 vertebral lesions were detected by MRI examination, including 20 core lesions and 13 vertebrae invasions, and the lesion detection rate of MRI examination was100%, and 7 cases were given enhanced scan, and a total of 10 core lesions were found,of which 9 were obvious even enhancement and 1 was obvious uneven enhancement in the enhanced scan. Conclusion The diagnosis of multiple spinal LCH is still based on pathological examinations such as puncture or surgery. MRI and CT have their own advantages and disadvantages in the diagnosis of disease. A correct judgment can be made after comprehensive analysis of imaging data and clinical features.
引文
[1]吴方方,高怡瑾,潘慈,等.儿童多脏器受累朗格汉斯细胞组织细胞增生症131例临床研究[J].中华儿科杂志,2 016,54(5):349-353.
[2]弓素青,石斌.肺郎格汉斯细胞组织细胞增生症的高分辨率C T表现[J].中国药物与临床,2016,16(9):1292-1293.
[3]高凯波,吴坚,胡罗健,等. CT诊断肺朗格汉斯细胞组织细胞增生症[J].中国医学影像技术,2016,32(5):741-744.
[4]张建,陈素芸,傅宏亮,等.儿童朗格汉斯细胞组织细胞增生症的PET/CT表现[J].中华核医学与分子影像杂志,2016,36(4):300-303.
[5]马雁南,涂彩霞,王傲雪.朗格汉斯细胞组织细胞增生症治疗进展[J].中国皮肤性病学杂志,2018,32(2):218-222.
[6]马斌,尹建军,等.下颌骨朗格汉斯细胞组织细胞增多症的影像表现与病理对照(2例报告并文献复习)[J].临床放射学杂志,2016,35(6):972-975.
[7]张立华,姜亮,许翔宇,等.成人脊柱朗格汉斯组织细胞增生症的影像学表现[J].中国医学影像技术,2017,33(9):1392-1396.
[8]黄文献,曾洪武,张龚巍,等.儿童孤立性垂体柄朗格汉斯细胞组织细胞增生症的MRI表现[J].中国医学影像学杂志,2016,24(4):245-247.
[9]庞超楠,袁慧书,刘晓光.脊柱多发郎格汉斯细胞组织细胞增多症的CT、MRI征象分析[J].中国医学影像技术,2017,33(3):449-453.
[10]张超,路坦.脊柱结核与脊柱炎的MRI影像鉴别价值研究[J].中国CT和MRI杂志,2016,14(7):115-117.
[11]许翔宇,王睿峰,姜亮,等.脊柱朗格汉斯细胞组织细胞增生症的诊断与治疗进展[J].中国脊柱脊髓杂志,2 016,26(10):939-943.
[12]曾金光.脊柱结核CT和MRI影像学特征比较研究[J].中国CT和MRI杂志,2017,15(1):116-118.
[2]弓素青,石斌.肺郎格汉斯细胞组织细胞增生症的高分辨率C T表现[J].中国药物与临床,2016,16(9):1292-1293.
[3]高凯波,吴坚,胡罗健,等. CT诊断肺朗格汉斯细胞组织细胞增生症[J].中国医学影像技术,2016,32(5):741-744.
[4]张建,陈素芸,傅宏亮,等.儿童朗格汉斯细胞组织细胞增生症的PET/CT表现[J].中华核医学与分子影像杂志,2016,36(4):300-303.
[5]马雁南,涂彩霞,王傲雪.朗格汉斯细胞组织细胞增生症治疗进展[J].中国皮肤性病学杂志,2018,32(2):218-222.
[6]马斌,尹建军,等.下颌骨朗格汉斯细胞组织细胞增多症的影像表现与病理对照(2例报告并文献复习)[J].临床放射学杂志,2016,35(6):972-975.
[7]张立华,姜亮,许翔宇,等.成人脊柱朗格汉斯组织细胞增生症的影像学表现[J].中国医学影像技术,2017,33(9):1392-1396.
[8]黄文献,曾洪武,张龚巍,等.儿童孤立性垂体柄朗格汉斯细胞组织细胞增生症的MRI表现[J].中国医学影像学杂志,2016,24(4):245-247.
[9]庞超楠,袁慧书,刘晓光.脊柱多发郎格汉斯细胞组织细胞增多症的CT、MRI征象分析[J].中国医学影像技术,2017,33(3):449-453.
[10]张超,路坦.脊柱结核与脊柱炎的MRI影像鉴别价值研究[J].中国CT和MRI杂志,2016,14(7):115-117.
[11]许翔宇,王睿峰,姜亮,等.脊柱朗格汉斯细胞组织细胞增生症的诊断与治疗进展[J].中国脊柱脊髓杂志,2 016,26(10):939-943.
[12]曾金光.脊柱结核CT和MRI影像学特征比较研究[J].中国CT和MRI杂志,2017,15(1):116-118.