儿童郎格罕细胞组织细胞增生症颅内侵犯的MRI表现.docVIP

儿童郎格罕细胞组织细胞增生症颅内侵犯的MRI表现 郑鹤琳，蔡金华（400014重庆，重庆医科大学附属儿童医院放射科） [摘要]　目的 探讨儿童郎格罕细胞组织细胞增生症（LCH）颅内侵犯的MRI表现特点。方法 回顾性分析2007年12月至2013年4月我院15例经手术或证实的LCH，其中男例，女4例，年龄113岁，病例均行头颅、垂体MR平扫及增强扫描。结果 下丘脑垂体病变10例，垂体后叶T1WI高信号消失及垂体柄增粗和强化。脑硬膜肿块2例脉络丛肿块1例T1WI等或稍低信号、T2WI低信号，增强后显著强化。主要累及小脑齿状核及基底节，呈对称性斑片状稍长T1稍长T2信号，强化不明显。结论 LCH颅内 [关键词] 郎格罕细胞组织细胞增生症；中枢神经系统；磁共振成像 [中图法分类号] R445.2 [文献码]　A MR imaging presentation of intracranial disease associated with Langerhans cell histiocytosis in children Zheng Helin, Cai Jinhua (Department of Radiology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China) [Abstract] Objective To investigate the MRI manifestations of intracranial lesions associated with Langerhans cell histiocytosis (LCH) in children. Methods Fifteen cases of LCH confirmed by surgery pathology or puncture biopsy were reviewed. Eleven patients were males, and 4 females, with age ranged from 1 to 13 years old. Plain and contrast enhanced MR imaging of head and pituitary were performed in all patients. The location, morphology, signal and enhanced patterns of the intracranial lesions were observed and analyzed. Results The most common intracranial finding was the hypothalamic-pituitary involvement which was demonstrated in ten patients (66.7%), including absence of normally high signal on T1WI in the posterior pituitary gland and thickening and abnormal contrast enhancement of the pituitary stalk. Dural mass was detected in 2 cases, and choroid-plexus mass was detected in 1 case. The masses were characterized by iso- or slightly hypo-intensity on T1WI and hypo-intensity on T2WI, with marked enhancement after administration of gadolinium. Brain parenchymal lesions were detected in five cases, in which 3 accompanied with hypothalamic-pituitary lesions. The parenchymal lesions mainly involved the cerebellar dentate nucleus and basal ganglia, and showed symmetrically patchy hypo-intensity on T1WI and hyper-intensity on T2WI, with no contrast enhancement. Con