大腸癌の診断に注腸X線検査は必要か―原則必要とする立場から：注腸X線検査の精度について（大腸内視鏡検査と対比して）

An Accuracy of Detecting a Colorectal Early Cancer by Barium Enema

要旨　早期大腸癌の存在診断についてX線検査と内視鏡検査を比較した．X線検査では前処置法を多量の等張性クエン酸マグネシウムと蠕動促進剤を使用した．使用したバリウムは75％であり，撮影フィルムは16枚であった．X線の描出能は89.4％に対して，内視鏡の発見率は92.5％であり，有意の差はなかった．X線の描出率は表面型と1.0cm以下の病変でやや低い傾向があった．大腸癌検診で便潜血検査が陽性である場合では，少なくとも2cm前後の病変を目指している．この条件ではX線検査で十分に病変の検査に役立つ．

　We have standardised a barium enema for detecting colorectal early cancer by a newly devised preparation. It involves about 75% w/v of barium suspension and the taking of 16 radiographs. The newly devised preparation consists of a greatly increased proportion of isotonic citrated magnesium solution (25 ml/kg BW) and an increase of the peristaltic drug (cysapride). We have been taking 16 radiographs in at least two directions in a colonic segment in order to detect early cancer. We have detected 295 lesions (295 cases) of early cancers (230 m cancers and 65 sm cancers) of the colon and rectum from Jan. 1992 to June 1997 in our department. 94 of these lesions were detected by using barium enema, and we made a study of the accuracy rate in detecting early cancer by barium enema. The rate of detection of early cancer by barium enema is 89%, compared with 93% by colonoscopy. There is not a significant difference between barium enema and colonoscopy for detecting early cancer. Therefore, in group checkups for colorectal cancer an examination by barium enema is as effective as colonoscopy for detecting early cancers.