Simpkins K C
Clin Radiol. 1977 Nov;28(6):601-8. doi: 10.1016/s0009-9260(77)80037-8.
Aphthoid ulceration is a strong indication and the earliest radiographic sign of Crohn's colitis. These small discrete ulcers were found by double contrast barium enema examination in 40 out of 91 patients with Crohn's colitis. Seen en face each ulcer appears as a central fleck of barium surrounded by a translucent halo set amidst a patch of normal mucosa. Their detection gives a more accurate assessment of the extent of disease. This information is required in order to plan medical or surgical treatment and can only be provided by meticulous double contrast examination or colonoscopy. Aphthoid ulceration has been demonstrated prior to the onset of bowel symptoms, and several years before the advent of severe colonic disease. The appearance of aphthoid ulcers in established quiescent disease has been observed to herald a relapse. The radiographic demonstration of the evolution of ulceration, which is illustrated, closely reflects what is seen on macroscopic examination of excised specimens and explains the characteristic patchiness and discontinuity of disease.
口疮样溃疡是克罗恩病性结肠炎的有力指征及最早的影像学征象。在91例克罗恩病性结肠炎患者中，通过双重对比钡剂灌肠检查发现了40例存在这些小而孤立的溃疡。从正面看，每个溃疡表现为钡剂的中央斑点，周围是半透明晕圈，位于一片正常黏膜之中。它们的发现能更准确地评估疾病范围。为了规划药物或手术治疗需要这一信息，而这只能通过细致的双重对比检查或结肠镜检查来提供。口疮样溃疡在肠道症状出现之前以及严重结肠疾病出现前数年就已出现。已观察到在已确诊的静止期疾病中出现口疮样溃疡预示着病情复发。文中所示的溃疡演变的影像学表现，与切除标本的宏观检查所见密切相符，并解释了疾病典型的斑片状及节段性特点。
