DYSPLASIA IN ULCERATIVE-COLITIS - IS RADIOGRAPHY ADEQUATE FOR DIAGNOSIS

PURPOSE: To determine the usefulness of barium enema examination in de tecting dysplasia in patients with ulcerative colitis. MATERIALS AND M ETHODS: 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 o f 22 areas of dysplasia were shown on radiographs. Dysplasia in the re ctum or sigmoid colon was depicted less frequently than that in other segments of the colon. Radiographic features were classified as obviou s nodular protrusions (seven lesions), irregular mucosa (five lesions) , or nodular protrusions with irregular mucosa (two lesions). Six of t he 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 dys plasia. CONCLUSION: Barium enema examination may be used as a compleme ntary method of cancer surveillance with endoscopy. These methods show about two-thirds of lesions associated with dysplasia.