Radiology, Vol 199, 85-90, Copyright © 1996 by Radiological Society of North America
Dysplasia in ulcerative colitis: is radiography adequate for diagnosis?
T Matsumoto, M Iida, F Kuroki, S Nakamura, T Yao, M Okada, A Iwashita, T Fuchigami and M Fujishima
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
PURPOSE: To determine to usefulness of barium enema examination in
detecting dysplasia in patients with ulcerative colitis. MATERIALS AND
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. CONCLUSION: 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.
