摘要
目的回顾性研究儿童下颌骨朗格汉斯细胞组织细胞增生症(LCH)的计算机体层摄影术(CT)表现,探讨CT在诊断LCH中的价值。方法收集中山大学附属第一医院自2006年1月至2016年7月中经手术病理证实的儿童下颌骨LCH患者的CT资料,同时在Sino Med数据库上以中文关键词及Pub Med数据库上以对应英文搜索语句对2016年及之前的文献进行无限定条件智能搜索,获取全文并人工进行筛选,对获得病例进行描述性统计分析。结果共获得18例病例,其中10例来自中山大学附属第一医院,8例来自文献。儿童下颌骨LCH的CT影像多表现为平扫期均匀软组织密度影(13/18),边缘多清晰(14/18),下颌骨皮质呈穿凿样破坏(17/18),可有明显的骨膜新生骨(11/18)但仅有轻微的边缘骨硬化带(5/18);牙根无推移或仅轻微受压推移,可伴牙囊破坏、牙根吸收(3/18)。增强扫描可见肿物轻至中度均匀强化(10/10),部分边缘可见环型强化带(5/10)。结论 CT在儿童下颌骨LCH的诊断中有重要的辅助作用,有助于该病的综合判断和正确治疗。
Objective Retrospectively analyses on the CT characteristics of Langerhans cell histiocytosis(LCH)of mandible in children with the purpose of investigating the diagnostic value of MSCT on LCH. Methods The CT images of LCH of mandible confirmed by pathology were collected in the First Affiliated Hospital of Sun Yat-sen University from Jan,2006 to July,2016. On the other hand,the Sino Med and Pubmed databases(-2016)were consulted with the key words related to LCH and mandible,without any other limit. Then,the full text of the target articles were acquired and picked out artificially.The Descriptive analysis was used as statistic method. Results Totally 18 cases were reviewed,including 10 cases from our hospital and 8 cases from the articles. The LCH of the mandible in children turned out to be a well-defined(14/18),punched-out lytic(17/18)mass with a homogeneous soft tissue density(13/18),which may had a periosteal reaction(11/18)and a slight bone line(5/18). The adjacent teeth might be pressed slightly or not. But the root histiocytosis of tooth and dental follicle might be eroded(3/18). The mass could have mild-middle enhancement(10/10)with a significant enhanced margin(5/10). Conclusion CT plays an important role in the diagnosis of LCH of mandible in children,as well as in the comprehensive assessment and therapy.
引文
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