| 李彦娇,宋学渊,王龙伦,罗明珠,朱进,何玲.儿童罗萨伊-多尔夫曼病影像学表现[J].中国医学影像技术,2025,41(10):1663~1666 |
| 儿童罗萨伊-多尔夫曼病影像学表现 |
| Imaging manifestations of Rosai-Dorfman disease in children |
| 投稿时间：2025-06-24 修订日期：2025-09-19 |
| DOI：10.13929/j.issn.1003-3289.2025.10.012 |
| 中文关键词: 组织细胞增生症,窦 儿童 诊断显像 |
| 英文关键词:histiocytosis, sinus child diagnostic imaging |
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| 中文摘要: |
| 目的 观察儿童罗萨伊-多尔夫曼病(RDD)影像学表现。方法 回顾性收集12例经病理证实的RDD患儿,其中 8例接受平扫CT(NCCT)+增强CT(CECT),2例接受NCCT+CECT+平扫MR(NCMR)+增强MR(CEMR),1例接受NCCT+NCMR+CEMR,1例接受NCCT+X线检查;观察RDD影像学表现。结果 12例中,7例为结内型、3例结外型、2例为混合型(淋巴结内外均受累)RDD。7 例结内 型RDD平扫及增强CT表现为双侧颈部多发淋巴结肿大,其中 5例NCCT呈均匀等密度、增强后呈轻-中度渐进性强化,2例病变内见低密度坏死区、增强后呈环形强化。3例结外型RDD中,1例累及鼻腔和后组筛窦,CT及MRI表现为以鼻中隔为中心的类圆形软组织肿块,增强后均呈中度不均匀强化,邻近骨质受压破坏;1例累及左侧髂骨和双侧顶骨,CT显示溶骨性骨质破坏伴明显骨膜反应及软组织肿块,增强后轻度强化;1例累及右侧股骨上段及左侧顶骨,X线及CT均示骨溶骨性破坏伴层状骨膜反应。2例混合型RDD均累及颅脑(1例累及左顶枕叶,1例累及双侧颞叶、左侧额叶和双侧枕叶)及胸部(双肺、纵隔及肺门淋巴结),脑实质病变CT均呈等密度,MRI表现为T1WI等或稍低信号、T2WI等-高混杂信号,部分呈脑回状,周围组织轻度水肿,增强后呈结节状或团块状显著强化;胸部病变CT表现为双肺多发结节状或小斑片状均匀高密度影,纵隔及肺门淋巴结均肿大。结论 儿童RDD影像学表现具有一定特征性,有助于诊断。 |
| 英文摘要: |
| Objective To explore the imaging manifestations of Rosai-Dorfman disease (RDD) in children. Methods A total of 12 children with RDD confirmed by pathology were retrospectively enrolled, including 8 cases underwent non-contrast CT (NCCT)+contrast enhanced CT (CECT), 2 cases underwent NCCT+CECT+non-contrast MR (NCMR)+contrast enhanced MR (CEMR), 1 case underwent NCCT+NCMR and CEMR, while 1 case underwent NCCT and X-ray examinations. Imaging manifestations of RDD in children were observed. Results Among 12 cases, intranodal type RDD was found in 7 case, extranodal type RDD in 3 cases, and mixed type (with both lymph nodes and extranodal sites affected) RDD were noticed in 2 cases. In 7 cases of intranodal type RDD, NCCT and CECT showed multiple lymph node enlargements in both sides of the neck, with uniform isodensity on NCCT and mild-moderate progressive enhancement in 5 cases, while with low-density necrotic area and ring-shaped enhancement in 2 cases. Among 3 cases of extranodal RDD, the lesion in 1 case involved nasal cavity and posterior group of ethmoid sinuses on CT and MRI, which developed circular soft tissue mass centered on nasal septum with moderate heterogeneous enhancement, also compressed the adjacent bone with destruction. In another case of extranodal RDD, CT showed that the lesion involved left ilium and bilateral parietal bones, with bone destruction accompanied by obvious periosteal reaction and soft tissue mass, which was mildly enhanced. In the rest 1 case of extranodal RDD, CT and X-ray film showed that the lesion involved the upper segment of right femur and left parietal bone, with osteolytic destruction accompanied by layered periosteal reaction. The lesions in both 2 cases of mixed type RDD involved brain (1 case involved left parieto-occipital lobe, 1 case involved bilateral temporal lobes, left frontal lobe and bilateral occipital lobes), presented as isodensity on CT and equal or slightly low signal intensity on T1WI, equal-high mixed signal intensity on T2WI, some shaped like brain gyral with mild edema of surrounding tissue, and nodular or mass-like significant enhancement. RDD involvements of bilateral lung, mediastinum and hilar lymph nodes were also observed in the above 2 cases, chest CT showed multiple nodular or small patchy uniform high-density shadows in bilateral lungs, as well as enlarged mediastinum and hilar lymph nodes. Conclusion Imaging manifestations of pediatric RDD had certain specificity, being helpful to diagnosis. |
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