颅外骨骼朗格汉斯细胞组织细胞增生症：根据影像学演变阶段的 MR 成像特征。

Extracranial skeletal Langerhans cell histiocytosis: MR imaging features according to the radiologic evolutional phases.

机构信息

Department of Radiology, Hallym University, Seoul 150-950, Korea.

出版信息

Clin Imaging. 2012 Sep-Oct;36(5):466-71. doi: 10.1016/j.clinimag.2012.01.002. Epub 2012 Jun 8.

DOI:10.1016/j.clinimag.2012.01.002

PMID:22920347

Abstract

PURPOSE

The purpose was to describe the magnetic resonance (MR) findings of extracranial skeletal Langerhans cell histiocytosis according to the radiologic evolutional phases.

MATERIALS AND METHODS

Twenty-two patients with pathologically confirmed extracranial skeletal Langerhans cell histiocytosis were included. The lesions were classified as early, mid, and late phases according to the radiologic evolutional phases. MR images were retrospectively analyzed regarding signal intensity, internal hypointense band, fluid levels, periosteal reaction, adjacent bone marrow and soft tissue abnormal signal, and patterns of contrast enhancement in each phase.

RESULTS

According to the radiologic evolutional phases, there were 4 patients with early phase, 16 with mid phase, and 2 with late phase. All cases showed hypointense to intermediate signal intensity on T1-weighted images. On T2-weighted images, 12 (55%) of the 22 lesions were hyperintense, and 10 (45%) showed intermediate signal. All lesions showed diffusely heterogeneous signal on T2-weighted images. Internal low-signal bands of the lesions were observed in 13 cases (59%). There were two cases with fluid levels in mid phase. Periosteal reaction was observed in 13 (59%) cases. Adjacent bone marrow or soft tissue abnormal signal was observed in 20 cases (91%), respectively. According to early, mid, and late phases, bone marrow and soft tissue abnormal signals were observed in 100%, 100%, and 0% cases, respectively. Soft tissue mass was seen in eight cases (36%). Ten (46%) lesions showed cortical destruction, including one patient with a pathologic fracture. Among 21 patients with contrast infusion, diffuse enhancement was observed in 19 patients (90%), and marginal and septal enhancement was seen in 2 patients (10%).

CONCLUSION

MR imaging was helpful in the diagnosis of extracranial skeletal Langerhans cell histiocytosis, particularly in early and mid phases.

摘要

目的

根据影像学演变阶段，描述颅外骨骼朗格汉斯细胞组织细胞增生症的磁共振（MR）表现。

材料与方法

纳入 22 例经病理证实的颅外骨骼朗格汉斯细胞组织细胞增生症患者。根据影像学演变阶段，病变分为早期、中期和晚期。回顾性分析各期 MR 图像的信号强度、内部低信号带、液性平面、骨膜反应、邻近骨髓和软组织异常信号以及对比增强模式。

结果

根据影像学演变阶段，4 例为早期，16 例为中期，2 例为晚期。所有病例在 T1WI 上均呈低信号到中等信号，在 T2WI 上，22 个病灶中有 12 个（55%）呈高信号，10 个（45%）呈中等信号。所有病灶在 T2WI 上均呈弥漫性不均匀信号。13 例（59%）病变内部可见低信号带。2 例（10%）在中期可见液性平面。13 例（59%）可见骨膜反应。20 例（91%）可见邻近骨髓或软组织异常信号，分别为 100%、100%和 0%。8 例（36%）可见软组织肿块。10 例（46%）显示皮质破坏，包括 1 例病理性骨折。21 例患者行对比剂增强扫描，19 例（90%）表现为弥漫性强化，2 例（10%）表现为边缘和间隔强化。