Kosiak Wojciech, Piskunowicz Maciej, Swieton Dominik, Bien Ewa, Batko Tomasz
Department of Paediatric, Haematology, Oncology, and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
J Clin Ultrasound. 2013 Mar-Apr;41(3):134-9. doi: 10.1002/jcu.21988. Epub 2012 Sep 18.
Langerhans cell histiocytosis (LCH) is an infrequent disorder of unknown origin associated with histiocytic proliferation. The bones' involvement (including cranial bones) is the most frequent manifestation of pediatric LCH. Imaging of skull LCH is based predominantly on conventional radiography, CT, scintigraphy, and sometimes MRI. The aim of the study was to investigate the role of sonography (US) in the diagnosis and monitoring of bone lesions in children with localized LCH of the skull.
Twenty-seven children (15 boys/12 girls, mean age 6.1 years) were diagnosed between 1991 and 2005 in the Department of Pediatrics at the Medical University of Gdansk, Poland. Fourteen children (52%) had localized LCH of the skull.
All lesions of the skull visible on CT were visualized on US examination. Overall, 30 focal lesions were revealed by US. The largest bone lesions were accompanied by changes within the adjacent soft tissues. CT revealed 26 lesions, the location and size of which corresponded to the lesions seen on US, but soft-tissue changes adjacent to the bony lesions were difficult to visualize.
The US appearance of focal LCH lesions in cranial bones in children is not pathognomonic, but is characteristic enough to suggest an initial diagnosis and to monitor the evolution of lesions during treatment. US should be considered an additional diagnostic tool for LCH of the skull. Although US of localized LCH cannot replace CT, it could reduce the number of follow-up CT examinations.
朗格汉斯细胞组织细胞增多症（LCH）是一种病因不明的罕见疾病，与组织细胞增殖有关。骨骼受累（包括颅骨）是儿童LCH最常见的表现形式。颅骨LCH的影像学检查主要基于传统X线摄影、CT、闪烁扫描，有时也采用MRI。本研究的目的是探讨超声（US）在诊断和监测颅骨局限性LCH患儿骨病变中的作用。
1991年至2005年期间，波兰格但斯克医科大学儿科共诊断出27例患儿（15例男孩/12例女孩，平均年龄6.1岁）。其中14例患儿（52%）患有颅骨局限性LCH。
CT上可见的所有颅骨病变在超声检查中均能显示。总体而言，超声检查发现了30个局灶性病变。最大的骨病变伴有相邻软组织的改变。CT显示了26个病变，其位置和大小与超声所见病变相符，但骨病变相邻的软组织改变难以显示。
儿童颅骨局灶性LCH病变的超声表现虽不具有特异性，但足以提示初步诊断并监测治疗期间病变的演变。超声应被视为颅骨LCH的一种辅助诊断工具。虽然局限性LCH的超声检查不能替代CT，但它可以减少随访CT检查的次数。
