James E M, Carlson H C
AJR Am J Roentgenol. 1978 May;130(5):825-30. doi: 10.2214/ajr.130.5.825.
Twenty-four patients with chronic ulcerative colitis and colon carcinoma who underwent barium enema examination prior to the diagnosis of cancer were studied in an attempt to correlate the radiographic appearance of the tumors with their biologic behavior, as well as to assess the accuracy of the barium enema in detection. Of the radiographically detected tumors, 65% displayed an annular infiltrative appearance, with the prime radiographic manifestation being relative nondistensibility of the involved segment. The remaining tumors had various appearances more typical of noncolitic colon cancer. Patients with infiltrative lesions had a much poorer prognosis than those with noninfiltrative lesions. Of 33 gross tumors described pathologically and/or surgically, only 70% were correctly detected by barium enema. It is suggested that periodic barium enema examinations are an unreliable means of following patients with ulcerative colitis if malignant degeneration is to be detected at an early and curative stage. Prophylactic proctocolectomy may be the best therapeutic approach.
对24例在癌症诊断前接受过钡灌肠检查的慢性溃疡性结肠炎合并结肠癌患者进行了研究，旨在将肿瘤的影像学表现与其生物学行为相关联，并评估钡灌肠在检测方面的准确性。在影像学检测出的肿瘤中，65%表现为环形浸润性外观，主要影像学表现为受累节段相对不可扩张。其余肿瘤具有更典型的非溃疡性结肠癌的各种表现。浸润性病变患者的预后比非浸润性病变患者差得多。在病理和/或手术描述的33个大体肿瘤中，钡灌肠仅正确检测出70%。如果要在早期和可治愈阶段检测出恶性病变，建议定期进行钡灌肠检查对于溃疡性结肠炎患者来说是一种不可靠的随访手段。预防性直肠结肠切除术可能是最佳治疗方法。
