【摘要】 目的探讨儿童朗格罕细胞组织细胞增生症(LCH)肝脏损伤的MRI表现及诊断价值。方法回顾性分析10例经病理证实的儿童LCH肝脏损伤患儿的临床及MRI资料,10例均行MRI平扫加增强,7例行磁共振胰胆管成像(MRCP)检查。结果 (1)常规MRI表现:肝右叶局灶性病变1例,肝门汇管区受累1例,肝门汇管区合并肝叶受累8例,其中合并肝左叶受累2例,全肝弥漫性受累5例,肝门淋巴结肿大8例。肝门汇管区异常信号8例,表现为轴位上与门静脉伴行条状长T1、长T2信号5例,合并结节状短T1脂肪信号3例;肝实质内片状长T1、长T2信号3例,多发结节状长T1、长T2信号5例,囊状信号2例,扩散加权成像(DWI)序列病变高信号6例。增强后病变不强化2例,环状强化5例,片絮状强化3例。(2)MRCP表现:累及肝总管及右肝管2例,胆总管及肝总管2例,肝总管及左、右肝管1例,左、右肝管2例,继发远端胆管扩张6例。(3)MRI分级:Ⅰ级1例,Ⅱ级1例,Ⅲ级3例,Ⅳ级5例。结论儿童LCH肝脏损伤具有相对特征性MRI表现,正确认识其特点可以为临床治疗方案的选择提供重要依据。更多还原

【Abstract】 Objective To investigate the MRI manifestations and values of Liver involvement of Langerhans cell histiocytosis in children.Methods Retrospective analysis of Clinical and MRI findings in 10 cases with surgery and pathology proved Langerhans cell histiocytosis in children.The unenhanced and contrast enhanced MRI were obtained in 10 patients,7 of the 10 children underwent MR cholangiopancreatography(MRCP).Results The lesion distribution:the right hepatic lobe lesions in 1 case,peripheral periportal lesions in 1 case,peripheral periportal lesions with hepatic lobe lesions in 8 cases,peripheral periportal lesions with left hepatic lobe lesions in 2 cases,peripheral periportal lesions with multiple lesions distributed in all liver lobes in 5 cases,enlargement of hilar lymph node in 8 cases.MRI signal characteristics:The periportal abnormalities were present as band like lesions alongside the central portal veins with hypointense on T1 WI and hyperintense on T2 WI in 5 cases,with hyperintense on T1 WI in 3 cases,patchy like lesions with hypointense on T1 WI and hyperintense on T2 WI in 2 cases,tubercle like lesions with hypointense on T1 WI and hyperintense on T2 WI in 5 cases,cystic like lesions in 2 cases,high signal on DWI in 6 cases.Lesions without enhancement in 2 cases,with ring like enhancement in 5cases,with patchy like enhancement in 3 cases.2,MRCP:Liver with the right hepatic injury in 2 cases,Liver with the right hepatic and the left hepatic injury in 2 cases,Liver with common bile duct injury in 1 case,the right hepatic and the left hepatic injury in 2 cases.3、MRI classification:class Ⅰ in 1 case,class Ⅱ in 1 case,class Ⅲ in 3 cases,class Ⅳ in 5 cases.Conclusion Liver involvement of Langerhans cell histiocytosis in children have typical MRI findings,it can provide an important basis for clinical protocols.更多还原