Hizawa K, Iida M, Aoyagi K, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Clin Radiol. 1996 Oct;51(10):706-8. doi: 10.1016/s0009-9260(96)80243-1.
To access concordance between radiological severity of aphthae and the more advanced features of Crohn's disease.
In 75 patients with an established diagnosis of Crohn's disease, we evaluated the radiological severity of colonic aphthae by meticulous double-contrast radiography. The degree of aphthae was defined as follows: AE0 = no lesions; AE1 = small nodules without barium flecks (lymphoid hyperplasia); AE2 = minute barium flecks < or = 1 mm in size with a translucent halo (umbilical or eroded lymphoid hyperplasia); AE3 = barium flecks varying from 2 mm to 5 mm in size (typical aphthoid ulcerations). We compared the degree of the lesions to the disease activity, and reviewed these sequential changes during a mean interval of 10 months.
AE3 lesions were more prevalent than AE1 or AE2 lesions in patients with active colitis. AE1 or AE2 lesions were found regardless of the involved bowel sites or the disease activity. Of 44 patients receiving a nutritional diet, 26 patients showed regression of the lesions although most of the patients still exhibited AE1 or AE2 lesions. In two of eight patients without the treatment, the lesions progressed.
In Crohn's disease, development of aphthoid ulcers is associated with disease activity; lymphoid hyperplasia may exist independently of disease activity.
评估口疮的放射学严重程度与克罗恩病更晚期特征之间的一致性。
在75例已确诊为克罗恩病的患者中，我们通过细致的双重对比造影X线检查评估结肠口疮的放射学严重程度。口疮程度定义如下：AE0 = 无病变；AE1 = 无钡斑的小结节（淋巴样增生）；AE2 = 直径小于或等于1毫米、带有半透明晕圈的微小钡斑（脐状或糜烂性淋巴样增生）；AE3 = 直径2毫米至5毫米的钡斑（典型口疮样溃疡）。我们将病变程度与疾病活动度进行比较，并在平均10个月的间隔期内观察这些连续变化。
在活动性结肠炎患者中，AE3病变比AE1或AE2病变更常见。无论肠道受累部位或疾病活动度如何，均可发现AE1或AE2病变。在44例接受营养饮食的患者中，26例患者的病变有所消退，尽管大多数患者仍表现为AE1或AE2病变。在8例未接受治疗的患者中，有2例病变进展。
在克罗恩病中，口疮样溃疡的出现与疾病活动度相关；淋巴样增生可能独立于疾病活动度存在。
