Dysplasia in ulcerative colitis: is radiography adequate for diagnosis?
OBJECTIVE
To determine to usefulness of barium enema examination in detecting dysplasia in patients with ulcerative colitis.


METHODS
Radiographic findings of 22 areas of dysplasia in 10 patients (seven men, three women; aged 34-81 years at diagnosis) were reviewed. Serial changes in radiographic features of four areas of dysplasia in three patients were retrospectively investigated.


RESULTS
Fourteen of 22 areas of dysplasia were shown on radiographs. Dysplasia in the rectum or sigmoid colon was depicted less frequently than that in other segments of the colon. Radiographic features were classified as obvious nodular protrusions (seven lesions), irregular mucosa (five lesions), or nodular protrusions with irregular mucosa (two lesions). Six of the seven areas of dysplasia shown as irregular mucosa were accompanied by minute spiculations in the margin of the colonic lumen. There was no correlation between radiologic features and histologic grade of dysplasia.


CONCLUSIONS
Barium enema examination may be used as a complementary method of cancer surveillance with endoscopy. These methods show about two-thirds of lesions associated with dysplasia.
Matsumoto
T
T
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Iida
M
M
Kuroki
F
F
Nakamura
S
S
Yao
T
T
Okada
M
M
Iwashita
A
A
Fuchigami
T
T
Fujishima
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000473:pathology; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011230:Precancerous Conditions / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D001466:Barium Sulfate