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Double Reading of Barium Enemas: Is It Necessary?

Cheri L. Canon1, J. Kevin Smith1, Desiree E. Morgan1, Brian C. Jones1, Sean C. Fell1, Philip J. Kenney1, Dino Ferrante2, Mark E. Lockhart1, Andrew O. Westfall3 and Robert E. Koehler1

1 Department of Radiology, University of Alabama at Birmingham, 619 S 19th St. Birmingham, AL 35249.
2 Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, AL 35249.
3 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35249.



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  		Fig. 1. —37-year-old woman with heme-positive stools. Overhead radiograph from double-contrast barium enema obtained with patient prone and gantry angled was initially interpreted as showing no rectal or sigmoid polyp. Second reader saw 6-mm pedunculated rectal polyp (arrow), finding with which first reader then agreed. Results of subsequent colonoscopy were negative. This example illustrates conversion of true-negative to false-positive reading with addition of second reader.

 


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  		Fig. 2. —50-year-old woman undergoing screening evaluation. Both readers reported 25-mm villous polyp (arrow) along right lateral wall of rectum best seen on this overhead radiograph from double-contrast barium enema obtained with patient prone and gantry angled. Endoscopy did not reveal this lesion, which was presumed to be stool, and findings of first and combined readings were considered false-positive.

 

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