Ott D J
Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Semin Roentgenol. 2000 Oct;35(4):333-41. doi: 10.1053/sroe.2000.17754.
CRC is a common malignancy, and reduced mortality can be achieved through detection and treatment of early cancers and by removal of colonic adenomas. Although current screening recommendations, especially in the average-risk individual, typically promote the use of FOBT and FS, a substantial minority of colonic cancers and many colonic adenomas are not detected by these methods. Modalities that examine the entire colon, such as the barium enema and colonoscopy, can detect most clinically important colorectal neoplasms; however, their additional costs and potential risks have limited their use as initial screening examinations. But recent changes in governmental policies regarding reimbursement for CRC screening and increasing emphasis on total colon examinations have altered these recommendations. This review on the accuracy of the DCBE has emphasized the detection of colonic polyps and cancers and has updated the changing role of this examination in screening patients at variable risk for CRC. The efficacy of the barium enema depends on many factors that radiologists must understand and control to perform accurate examinations. Current recommendations for CRC screening and approved reimbursement of the barium enema for that purpose provide a new impetus to radiologists to maintain and improve their skills in performing and interpreting this radiologic examination. The barium enema may have a future in the new millennium.
结直肠癌是一种常见的恶性肿瘤，通过早期癌症的检测与治疗以及结肠腺瘤的切除可降低死亡率。尽管当前的筛查建议，尤其是针对平均风险个体的建议，通常提倡使用粪便潜血试验（FOBT）和乙状结肠镜检查（FS），但这些方法无法检测出相当一部分的结肠癌和许多结肠腺瘤。诸如钡灌肠和结肠镜检查等能检查整个结肠的方式，可以检测出大多数具有临床重要性的结直肠肿瘤；然而，它们额外的费用和潜在风险限制了其作为初始筛查检查的应用。但政府近期在结直肠癌筛查报销政策方面的变化以及对全结肠检查的日益重视改变了这些建议。这篇关于双对比钡灌肠（DCBE）准确性的综述强调了结肠息肉和癌症的检测，并更新了此项检查在筛查不同结直肠癌风险患者中不断变化的作用。钡灌肠的效果取决于许多因素，放射科医生必须了解并控制这些因素才能进行准确的检查。当前的结直肠癌筛查建议以及为此目的批准的钡灌肠报销政策，为放射科医生维持和提高其进行及解读这项放射学检查的技能提供了新的动力。钡灌肠在新千年可能会有新的前景。
