儿童颞骨郎格罕细胞组织细胞增生症的CT诊断与鉴别诊断

目的总结7例儿童颞骨郎格罕组织细胞增生症（LCH）的CT影像特点，提高CT诊断准确性。方法回顾性分析我院2005年3月～2011年5月期间经手术病理证实的儿童颞骨LCH7例，术前均行颞骨螺旋cT轴位薄层平扫（层厚2-3mm），3例行增强扫描，分析其cT表现。结果5例为颞骨单发病灶，2例颅骨有多发病灶；5例cT表现为颞骨乳突部的溶骨性骨质破坏．2例颞骨乳突部及颞骨鳞部的骨质破坏，1例听小骨骨质破坏，7例颞骨骨质破坏区均见软组织肿块形成，软组织肿块突入外耳道，3例侵入左侧中颅窝，2例侵入后颅窝，2例肿块侵及颞下窝，4例肿块累及鼓室及乳突窦，3例乙状窦前壁骨质破坏缺损；2例累及面神经管乳突段，1例见多发点状残留骨，7例均未见明显骨膜反应及骨质硬化。结论儿童颞骨LCH好发于颞骨乳突部，CT表现为溶骨性骨质破坏并局部软组织肿块形成，无骨质硬化及骨膜反应，软组织肿块强化明显，cT检查可以提高本病的诊断准确性。

CT diagnosis of temporal bone Langerhans cell histiocytosis in children

Objective To evaluate the CT features of pediatric temporal bone Langerhans cell histiocytosis （LCH）. Methods CT of 7 children pathologically confirmed with temporal bone LCH between March 2005 and May 2011 was retrospectively analyzed. Axial unenhanced temporal bone CT scan with 2-3 mm slice thickness was performed in all patients and contrast-enhanced scans were also acquired in 3 children. The CT features were reviewed. Restdts The temporal bone lesions were solitary in 5 patients and multiple skull lesions were found in 2 cases. CT showed bone de- struction involving the mastoid （5 patients）, temporal bone squama （2）, and middle ear ossicles （1）. Soft tissue mass- es were noted on all 7 patients with tumor extension into the external auditory canal （7）, invasions of left middle cra- nial fossa （3）, posterior fossa （2）, temporal fossa （2）, middle ear and mastoid air cells （4）, sigmoid sinus groove; mastoid segment of facial nerve canal （2）. Multiple small residual bone fragments were noted in＇ one patient. No pe- riosteal reaction or bone sclerosis was found in any of the 7 patients. Conclusion Pediatric temporal bone LCH origi- nates in the mastoid bone with CT features of bone destruction and enhancing soft tissue mass, no bone sclerosis or pe- riosteal reaction.