2）注腸X線

Barium Enema in Mass Screening for Detection of Colorectal Early Cancer

要旨　早期大腸癌のスクリーニング検査としての注腸X線検査法について概説した．近年，注腸X線検査は新たなデジタル撮影装置の進歩や前処置法・造影剤の改良などにより，X線画質や表面型腫瘍の示現能が向上してきている．また，腸管のスパスム予防や被検者の苦痛緩和のため，前処置や前投薬に様々な工夫もなされてきている．早期大腸癌の注腸X線での見逃し原因の多くは，前処置不良や腸管のスパスム，不十分な読影によるものであり，大半は見直しにて指摘可能である．これらの点を念頭に置いて，質の高いX線画像の撮影を行い，注意深い読影を心がければ，注腸X線検査は早期大腸癌のスクリーニング検査としての役割を十分に果たしうると考える．

　In recent years, the quality of radiographic film and the detectability of surface type tumors by barium enema studies have been improving by owing to developments in digital photographic equipment, newly devised preparation and high-density barium medium. Moreover, bowel preparation and pre-medication for suppression of peristaltic motion and reduction of pain in barium enema have been of great helps. The main causes of oversights in barium enema studies were misjudgments of radiographic films, intestinal spasm and insufficient barium coating of the mucosa. Overlooked lesions are able to be pointed out during re-checkups, so, by avoiding the former causes of misdiagnosis and by meticulous reading of radiographic films, the use of barium enema can be effective in group checkups for screening of early colorectal cancer.