Krupniewski Leszek, Palczewski Piotr, Gołębiowski Marek, Kosińska-Kaczyńska Katarzyna
1 Department of Clinical Radiology of the Medical University of Warsaw, Warsaw, Poland.
Pol J Radiol. 2012 Jan;77(1):72-6. doi: 10.12659/pjr.882586.
Although sickle-cell anemia (SCA) is common in black Americans, Sub-Saharan Africa and in the Mediterranean area, the disease is rare in the temperate climate zone. The manifestations of the disease are related mainly to the production of abnormal hemoglobin that leads to organ ischemia and increased susceptibility to infection caused by functional asplenia.
The authors present CT findings in a 39-year-old black woman diagnosed due to abdominal pain, lymphadenopathy and fever. CT of the thorax and abdomen demonstrated changes in the liver, spleen, and skeletal system suggestive of SCA complicated with spondylodiscitis in the thoracic spine.
Hepatomegaly and small calcified spleen are typical findings in older homozygotic patients with SCA. The lesions in the skeleton may be related either to intramedullary hematopoiesis or osteonecrosis and osteomyelitis. In the latter case, diffuse osteosclerosis and H-shaped vertebrae are most typical. Tuberculous spondylodiscitis is characterized by the location in the thoracic region, preferential involvement of anterior elements, relative sparing of intervertebral discs, and cold abscesses.
尽管镰状细胞贫血（SCA）在美国黑人、撒哈拉以南非洲地区和地中海地区较为常见，但在温带气候区这种疾病却很罕见。该疾病的表现主要与异常血红蛋白的产生有关，异常血红蛋白会导致器官缺血，并因功能性无脾而增加感染易感性。
作者展示了一名39岁黑人女性的CT检查结果，该患者因腹痛、淋巴结肿大和发热而被诊断。胸部和腹部CT显示肝脏、脾脏和骨骼系统有变化，提示患有SCA并伴有胸椎椎体椎间盘炎。
肝肿大和脾脏小钙化是老年纯合子SCA患者的典型表现。骨骼病变可能与骨髓内造血或骨坏死及骨髓炎有关。在后一种情况下，弥漫性骨硬化和H形椎体最为典型。结核性椎体椎间盘炎的特征是位于胸部区域，前部结构优先受累，椎间盘相对 spared，以及冷脓肿。 （注：原文中“relative sparing of intervertebral discs”这里的“spared”可能有误，推测应为“spared”，暂按此翻译为“相对 spared”，可进一步确认原文）
