Williams H J, Stephens D H, Carlson H C
AJR Am J Roentgenol. 1981 Aug;137(2):315-22. doi: 10.2214/ajr.137.2.315.
Double-contrast examination and proctosigmoidoscopy were performed in 240 patients with ulcerative colitis and 60 patients with granulomatous colitis. Both examinations were evaluated for accuracy of detection of disease, accuracy of classification of disease, and the ability of one examination to add information not gained by the other. Endoscopy was more sensitive than double-contrast examination in detection of disease of the distal colon and rectum in 18% of cases of ulcerative colitis and 17% of cases of granulomatous colitis. Double-contrast examination was more specific than proctosigmoidoscopy in differentiation of disease in cases of ulcerative colitis; endoscopy incorrectly classified 11% of cases as granulomatous colitis, and double-contrast examination misclassified only one case (less than 1%). Neither examination misclassified a case of granulomatous colitis as ulcerative colitis. Finally, double-contrast examination demonstrated disease proximal to the range of the proctosigmoidoscope of a greater severity than that seen endoscopically in 24% of patients with ulcerative colitis and 70% of patients with granulomatous colitis. Radiographic variations in disease presentation occasionally caused difficulty in classification. Double-contrast examination and proctosigmoidoscopy are complementary, and both should be used in evaluating patients with inflammatory disease of the colon.
对240例溃疡性结肠炎患者和60例肉芽肿性结肠炎患者进行了双重对比检查和直肠乙状结肠镜检查。对这两种检查在疾病检测准确性、疾病分类准确性以及一种检查补充另一种检查未获得信息的能力方面进行了评估。在18%的溃疡性结肠炎病例和17%的肉芽肿性结肠炎病例中，内镜检查在检测远端结肠和直肠疾病方面比双重对比检查更敏感。在溃疡性结肠炎病例中，双重对比检查在疾病鉴别方面比直肠乙状结肠镜检查更具特异性；内镜检查将11%的病例错误分类为肉芽肿性结肠炎，而双重对比检查仅误诊1例（不到1%）。两种检查均未将肉芽肿性结肠炎病例误诊为溃疡性结肠炎。最后，在24%的溃疡性结肠炎患者和70%的肉芽肿性结肠炎患者中，双重对比检查显示直肠乙状结肠镜检查范围近端的疾病比内镜所见更为严重。疾病表现的影像学差异偶尔会导致分类困难。双重对比检查和直肠乙状结肠镜检查具有互补性，在评估结肠炎症性疾病患者时均应使用。
