Bolin S, Franzén L, Nilsson E, Sjödahl R
Department of Diagnostic Radiology, University of Linköping, Sweden.
Cancer. 1988 May 15;61(10):1999-2008. doi: 10.1002/1097-0142(19880515)61:10<1999::aid-cncr2820611012>3.0.co;2-w.
Radiologic examinations preceding the diagnosis of colorectal carcinomas were retrospectively scrutinized in 708 patients with 731 carcinomas that were radiographically investigated 741 times. Sixty-four lesions were missed 74 times, giving a 90% sensitivity of the radiographic methods used. Of the errors, 82% were perceptive, and 3% were interpretative. Eleven examinations in nine patients revealed no lesions, although the examinations were done within 2 years of the diagnosis of a carcinoma. Missed lesions were more common than expected in the cecum and the ascending colon (P less than 0.001), and 18% of the patients had multiple tumors (expected incidence 3.6%, P less than 0.001). The median delay in diagnosis was 20 months, and patients whose diagnosis was delayed for a long time tended to have more advanced carcinomas at diagnosis. As a lesion was identified either at the initial examination or retrospectively 730 of 741 times, the potential sensitivity of the radiographic methods used was 99%. It is concluded that barium enema is still an excellent method for the detection of colorectal carcinoma provided that perceptive errors can be minimized.
对708例患有731处结肠癌的患者进行了回顾性研究，这些患者接受了741次影像学检查以诊断结肠癌。74次检查中漏诊了64处病变，所使用的影像学检查方法的敏感性为90%。在这些错误中，82%是感知性的，3%是解释性的。9例患者的11次检查未发现病变，尽管这些检查是在结肠癌诊断的2年内进行的。盲肠和升结肠的漏诊病变比预期更常见（P<0.001），18%的患者有多个肿瘤（预期发生率3.6%，P<0.001）。诊断的中位延迟时间为20个月，诊断延迟时间长的患者在诊断时往往有更晚期的癌症。由于在741次检查中，有730次在初次检查或回顾性检查中发现了病变，所使用的影像学检查方法的潜在敏感性为99%。结论是，只要能将感知性错误降至最低，钡灌肠仍然是检测结肠癌的一种优秀方法。
