From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (M.S.L.); and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco Veterans Affairs Medical Center, San Francisco, Calif (J.Y.).
Radiology. 2014 Nov;273(2 Suppl):S160-80. doi: 10.1148/radiol.14140531.
Colorectal cancer screening is thought to be an effective tool with which to reduce the mortality from colorectal cancer through early detection and removal of colonic adenomas and early colon cancers. In this article, we review the history, evolution, and current status of imaging tests of the colon-including single-contrast barium enema, double-contrast barium enema, computed tomographic (CT) colonography, and magnetic resonance (MR) colonography-for colorectal cancer screening. Despite its documented value in the detection of colonic polyps, the double-contrast barium enema has largely disappeared as a screening test because it is widely perceived as a labor-intensive, time-consuming, and technically demanding procedure. In the past decade, the barium enema has been supplanted by CT colonography as the major imaging test in colorectal cancer screening in the United States, with MR colonography emerging as another viable option in Europe. Although MR colonography does not require ionizing radiation, the radiation dose for CT colonography has decreased substantially, and regular screening with this technique has a high benefit-to-risk ratio. In recent years, CT colonography has been validated as an effective tool for use in colorectal cancer screening that is increasingly being disseminated.
结直肠癌筛查被认为是一种有效的工具，可以通过早期发现和切除结肠腺瘤和早期结肠癌来降低结直肠癌的死亡率。本文回顾了结肠成像检查（包括单对比钡灌肠、双对比钡灌肠、计算机断层扫描（CT）结肠成像和磁共振（MR）结肠成像）在结直肠癌筛查中的历史、演变和现状。尽管双对比钡灌肠在检测结肠息肉方面具有已被记录的价值，但由于其被广泛认为是一种劳动强度大、耗时且技术要求高的检查程序，它已在很大程度上不再作为筛查检查。在过去十年中，钡灌肠已被 CT 结肠成像取代，成为美国结直肠癌筛查的主要成像检查，而 MR 结肠成像在欧洲也成为另一种可行的选择。尽管 MR 结肠成像不需要电离辐射，但 CT 结肠成像的辐射剂量已大大降低，并且定期使用该技术进行筛查具有很高的收益风险比。近年来，CT 结肠成像已被验证为一种有效的结直肠癌筛查工具，并且正在得到越来越广泛的应用。
