RESUMEN
Accuracy of the barium enema examinations in diagnosis of the depth of invasion of the small carcinomas of the colon was reviewed. The materials included 101 sessile carcinomas and 12 small advanced carcinomas that were 20 mm or less in diameter. The carcinomas with stalks and the depressed type early carcinomas (Type IIc) were excluded from the study, because the former were impossible to the nature by X-ray examinations and the latter were extremely rare. Presence of the depressed portions on the surface of the elevated lesions observed in the frontal views and the degree of the deformity observed in the profile views of the lesions were correlated with the pathological specimen and the accuracy of the radiological diagnosis of the depth of invasion was estimated. The cases with gross malignant cell invasion into the submucosal or the deeper layers were diagnosed correctly with present radiological diagnostic criteria. But, those with a small amount of malignant cell invasion into the submucosal layer or the cases with malignant cell invasion limited to the mucosal layer (intramural cancer) were not always correctly diagnosed and there was a variety in diagnosis of the depth of invasion in this group. With the current radiological techniques, proper profile views of the lesions were not obtained in quite a few cases, nor the surface characteristics of the small elevated lesions were well documented. It would probably be possible to improve these techniques and to improve diagnostic accuracy to some extent, but with certain limitations.