Colon and Rectum Barium Studies

Abstract

The overall volume of barium enemas performed in the United States has decreased considerably over the past two decades as a result of greater utilization of other diagnostic tests such as colonoscopy, CT, and, most recently, CT colonography. Nevertheless, the barium enema continues to have a role in modern radiology practice. Barium examinations of the colon are designed primarily to detect mucosal lesions such as colonic polyps and cancers. In particular, the double-contrast barium enema has been advocated as a viable alternative to colonoscopy and CT colonography for colon cancer screening (Kung et al. 2006) and as a useful test for evaluating the proximal colon in patients with incomplete colonoscopy (Chong et al. 2002). Barium studies also have the ability to demonstrate intramural and extrinsic lesions involving the colon that are more difficult to recognize at colonoscopy. In such cases, the full extent of these lesions is better assessed by cross-sectional imaging studies such as CT and MR.