CAJ | 학술논문

目的：探讨儿童脊柱嗜酸性肉芽肿的影像学表现。方法回顾性分析深圳市儿童医院2007年1月至2013年12月经手术病理证实的12例儿童脊柱嗜酸性肉芽肿的影像学资料，男性5例，女性7例；年龄1~13岁，平均年龄为5岁3个月。12例均行常规 X 线检查，6例行 CT 检查，11例行 MRI 检查。结果12例脊柱嗜酸性肉芽肿中，10例单发病灶，2例多发病灶，共15个病灶，其中颈椎2个，胸椎 5个，腰椎8个。15个病变均位于椎体，2个同时累及椎体附件。X 线表现为不同程度的椎体变扁，椎间隙正常或增宽。CT 表现为椎体骨质破坏，部分病灶周围可见骨质硬化。MRI 表现为破坏的椎体 T1 WI 呈等信号或稍低信号，T2 WI 呈等信号或稍高信号。椎体变扁呈楔形或呈盘状改变。3个病灶椎旁软组织肿块形成，其信号特点与病变椎体相仿，其中 2个突向椎管内压迫硬膜囊及脊髓。3例引起脊柱不同程度后凸畸形。病灶邻近椎间盘信号正常。4例 MRI 增强扫描显示受损椎体及椎旁软组织肿块不同程度强化。结论儿童脊柱嗜酸性肉芽肿影像学表现具有一定特征性，MRI 表现最具诊断价值，可为临床诊治提供可靠的影像学依据。
목적：탐토인동척주기산성육아종적영상학표현。방법회고성분석심수시인동의원2007년1월지2013년12월경수술병리증실적12례인동척주기산성육아종적영상학자료，남성5례，녀성7례；년령1~13세，평균년령위5세3개월。12례균행상규 X 선검사，6례행 CT 검사，11례행 MRI 검사。결과12례척주기산성육아종중，10례단발병조，2례다발병조，공15개병조，기중경추2개，흉추 5개，요추8개。15개병변균위우추체，2개동시루급추체부건。X 선표현위불동정도적추체변편，추간극정상혹증관。CT 표현위추체골질파배，부분병조주위가견골질경화。MRI 표현위파배적추체 T1 WI 정등신호혹초저신호，T2 WI 정등신호혹초고신호。추체변편정설형혹정반상개변。3개병조추방연조직종괴형성，기신호특점여병변추체상방，기중 2개돌향추관내압박경막낭급척수。3례인기척주불동정도후철기형。병조린근추간반신호정상。4례 MRI 증강소묘현시수손추체급추방연조직종괴불동정도강화。결론인동척주기산성육아종영상학표현구유일정특정성，MRI 표현최구진단개치，가위림상진치제공가고적영상학의거。
Objective To study the imaging findings of spine eosinophilic granuloma(EG)in children. Methods The imaging findings of 12 patients with eosinophilic granuloma of spine confirmed by surgery were analyzed retrospectively. 12 ca-ses were underwent DR,6 cases were underwent CT,and 11 cases were underwent MRI. Results Of the 12 cases with spine EG,there were solitary(10 patients)and multiple lesions(2 patients),totally 15 lesions were found. 15 spine EG lesions in-cluded 2 cervical vertebrae,8 thoraeic vertebraeand 8 lumbar bertebrae. All spine EG lesions were in vertebral bodies,of those, 2 lesions involved into appendages. DR demonstrated flatten vertebrae in different degree with normal or enlarged intervertebral space. CT showed destruction of bone with surrounding osteosclerosis partially. 12 cases examined by MR showed abnormality in the shape and signal of bone. The lesions carried slightly hypointense on T1 WI and hyperintense on T2 WI. 15 cases lesions presented as flattened vertebra or disk change. 3 cases showed soft tissue swelling around the vertebrae and there were the same signal characteristics between the vertebrae and soft tissue. 2 of them oppressed the dural sac and spinal cord. 3 of them presen-ted as kyphosis deformity,and the internertebral disc was normal. Of the 4 patients had Gd-DTPA enhanced MRI,different de-grees of enhancement could be assessed. Conclusion The characteristic imaging features can be seen in spine eosinophilic granuloma in children,the most accurate diagnosis values cand be obtained by MRI,it can be a reliable imageology evidence for clinical diagnosis and treatment.