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目的:探讨结肠癌术后复发的钡灌肠与CT诊断.材料与方法:75例结肠癌,有43例术后复发(57％),28％局部复发同时合并远处转移,23％单纯远处转移.术后1~2年局部复发者为57％(12/21),远处转移者为63％(14/22).CT扫描层厚和层间距均为8MM,吻合口部位加作薄层扫描.结肠双重造影用70％W/V混悬钡液.结果:结肠癌术后复发的主要CT表现:5例可见吻合口区肠腔内不规则软组织结节影;9例见吻合口周围或骶骨前方不规则软组织块影;3例肿块中央见低密度坏死区;1例伴有斑片状及点状钙化灶.此外尚有肠壁增厚,边缘不规则以及相邻组织器官受侵犯.术后远处转移常见部位为肝脏.结肠双重造影主要表现为吻合口偏心性或不规则性狭窄;吻合口区充盈缺损,邻近的肿块效应或“双边征”.结论:钡灌肠对吻合口和肠腔内的复发检查敏感,且较准确;而CT对检查结肠癌术后复发的位置、大小、范围、腔外肿块或远处转移均敏感.CT与钡灌肠检查相结合,能最大限度地发现结肠癌术后复发.术后4个月基础CT扫描及术后基础钡灌肠检查有利于在术后正常改变过程中检出更小的复发灶.“,”Objective: To evaluate the barium enema (BE) and CT in the diagnosis of postoperative recurrence of colonic carcinoma.Materials and Methods:Of 75 cases of colonic carcinoma, 53 (57%), recurred after surgery. CT scanning of anastomotic stoma site was performed with 8mm slice thickness and 8mm interval. For double contrast BE, 70% W/V barium suspension was used.Results:The main CT findings of recurrence were as follows: irregular soft tissue nodules at the anastomotic stoma (n=5), mass around the anastomotic stoma or in front of the sacral bone (n=9), central necrosis of the mass (n=3), mottling and punctate calcification (n=1). Besides ,thickened intestinal wall, irregular margin and involvement of adjacent organ were seen. Liver was the common site of metastasis. On double contrast BE, the main manifestation was eccentric and irregular stenosis of anastomotic stoma, filling defect and “double margin” sign.Conclusion: In the diagnosing of the postoperative recurrence of colonic carcinoma, BE is rather accurate for observing the anastomotic stoma and intestinal lumen, while CT is good for demonstrating the site, size, extent, extraluminal mass and distant metastasis. Coupled CT with BE, postoperative recurrence of colonic carcinoma can be detected to the greatest possibility. It will be helpful for detecting smaller lesions if CT scanning and BE are made as a baseline in 4 month after surgery.