Williams S M, Harned R K
Curr Probl Diagn Radiol. 1983 Mar-Apr;12(2):1-41. doi: 10.1016/0363-0188(83)90024-5.
With experience, air contrast examination of the esophagus, stomach, and duodenum can be performed routinely as quickly and easily as the standard UGI. The air contrast examination is superior for detection of small gastric polyps and the Japanese have found it superior for detection of early carcinoma. The postoperative stomach and the fundus and cardia are most easily examined by air contrast. Clear superiority in the diagnosis of peptic ulcers and peptic esophagitis has not been proved. The most accurate routine examination may be a multiphasic or combined approach utilizing air contrast views as well as filled compression views and careful fluoroscopy. With respect to the colon, we do not suggest that air contrast BE must be done exclusively. However, it is superior for the detection of polyps and small carcinomas. The technique should be available in all radiology departments and should be an integral part of the evaluation of patients at increased risk of developing carcinoma. This includes patients over 40 years of age, with chronic ulcerative colitis, familial multiple polyposis or Gardner's syndrome, family history of inherited cancer, and medical history of adenomatous polyps, colorectal cancer, or female genital cancer. In addition, air contrast enema should be utilized for the sensitive and accurate evaluation of early inflammatory bowel disease. Finally, with respect to the colon examination one fact must be stressed. Irregardless of full column or air contrast method, most missed lesions are due to poor bowel preparation, poor technique, or perceptive error by the radiologist. There can be no substitute for a clean colon, meticulous attention to technical details, and careful review of the radiographs.
随着经验的积累，食管、胃和十二指肠的气钡双重造影检查可以像标准上消化道造影一样常规、快速且轻松地进行。气钡双重造影在检测小胃息肉方面更具优势，日本人发现它在早期癌的检测方面也更具优势。气钡双重造影最容易用于检查术后胃以及胃底和贲门。在消化性溃疡和消化性食管炎的诊断方面尚未证实其具有明显优势。最准确的常规检查可能是采用气钡双重造影、充盈压迫造影以及仔细的荧光透视检查相结合的多相检查方法。关于结肠，我们并不建议必须仅进行气钡双重结肠造影。然而，它在息肉和小癌的检测方面更具优势。这项技术应在所有放射科都能开展，并且应成为对患癌风险增加的患者进行评估的一个组成部分。这包括40岁以上、患有慢性溃疡性结肠炎、家族性多发性息肉病或加德纳综合征、有遗传性癌症家族史以及有腺瘤性息肉、结直肠癌或女性生殖系统癌症病史的患者。此外，气钡双重灌肠造影应用于对早期炎症性肠病进行敏感且准确的评估。最后，关于结肠检查必须强调一个事实。无论采用全结肠造影还是气钡双重造影方法，大多数漏诊的病变都是由于肠道准备不佳、技术欠佳或放射科医生的感知错误。没有什么能替代清洁的结肠、对技术细节的精心关注以及对X线片的仔细阅片。
