Imaging appearances of spinal Langerhans cell histiocytosis in adult / 中国医学影像技术

ABSTRACT

Objective To explore the imaging appearances of adult Langerhans cell histiocytosis (LCH) in spine and improve the awareness of this disease.Methods Imaging appearances of 29 patients with adult LCH in spine confirmed by clinic and pathology were analyzed retrospectively and the lesions number,location,the type of bone destruction,paravertebral and intraspinal and MRI signal and enhancement characters were evaluated.Results The total sum of spine lesions was 48 including 26 cervical lesions,17 thoracic lesions and 5 lumbar-sacrum lesions among 29 cases,and 11 cases involved multiple segments.Bone destruction was located in vertebral body in 15 cases accounting for 51.72％ (15/29),and 14 cases involved posterior arch accounting for 48.28％ (14/29).Sclerosis rim was found in 10 cases (10/29,34.48％) and bone sclerosis was found in 4 cases (4/29,13.79％).75.86％ (22/29) LCH extended to paravertebral space and the incidence of compressed fracture was 48.28％ (14/29),4.13％ (7/29) appeared as vertebra plana.On T2-weighted image,LCH showed iso-or-hypointensity (11/19,57.89％),hyperintensity (6/19,31.58％),heterogenous signal (2/19,10.53％).On MR enhanced scan,94.12％ (16/17) cases was significant enhanced,5.88％ (1/17) was moderate enhanced.Conclusion Cervical was commonly found in adult LCH,and bone destruction was mainly in vertebrae.It may involve one or multiple spine segments and bone destruction may be continuous or skip distribution.Vertebra plana was not rare.Bone sclerosis around bone destruction may be helpful for diagnosing LCH.