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目的探讨脊柱多发郎格汉斯细胞组织细胞增多症(LCH)的CT、MRI征象。方法回顾性分析13例经病理证实的脊柱多发LCH患者的影像学检查资料,13例均接受CT检查(1例增强扫描),其中12例接受MR检查(6例增强扫描)。结果 13例中,单中心病变8例,多中心病变5例。共34个病变脊椎,其中核心病变脊椎19个,邻近侵犯脊椎15个。18个(18/19,94.74%)核心病变脊椎存在不同形态、程度的压缩骨折。13例患者共34个病变脊椎CT均表现为溶骨性骨质破坏;19个核心病变脊椎中,18个(18/19,94.74%)骨皮质不完整、可见椎旁软组织肿块。MRI显示12例患者共33个病变脊椎,包括核心病变脊椎18个,邻近侵犯脊椎15个,T1WI均呈等、稍低或低信号,T2WI呈稍高或高信号,脂肪抑制序列呈高信号;17个(17/18,94.44%)核心病变脊椎有椎旁软组织肿块。结论脊柱多发LCH的CT、MRI表现具有一定特征性,加深对本病影像表现的认识可提高诊断和鉴别水平,但确诊需依靠病理检查。
Objective To investigate the CT and MRI features of multiple Langerhans cell histiocytosis (LCH) in the spine. Methods Thirteen patients with pathologically confirmed spondylolisthesis of LCH were retrospectively reviewed. All of the 13 patients underwent CT scan (1 enhanced scan) and 12 patients underwent MR scan (6 enhanced scan). Results Of the 13 cases, 8 were single-center lesions and 5 were multiple-center lesions. A total of 34 lesions of the spine, including 19 lesions of the spinal cord center, adjacent to violations of the spine 15. Eighteen (18/19, 94.74%) of the core lesions had different morphological and compressive fractures. Thirteen patients with 34 lesions showed spondylolisthesis osteolytic bone destruction. Of the 19 core lesions, 18 (18/19, 94.74%) had incomplete cortical bone with paravertebral soft tissue mass. MRI showed a total of 33 lesion vertebrae in 12 patients, including 18 vertebrae of core lesion and 15 adjacent vertebrae. T1WI showed slightly lower or lower signal, T2WI slightly higher or higher signal, and fat suppression sequence showed higher signal. Seventeen (17 / 18,94.44%) of the core lesions had paravertebral soft tissue mass in the spine. Conclusion CT and MRI manifestations of spine multiple LCH have certain characteristics. To deepen the understanding of the imaging manifestations of the disease can improve the level of diagnosis and identification, but the diagnosis depends on the pathological examination.