食管气道瘘的CT评估

目的 探讨食管气道瘘的CT表现,提高对食管气道瘘的诊断和认识.方法 选取2013年2月至2015年4月间明确诊断,且临床及影像资料齐全的55例食管气道瘘患者,选取食管气道瘘病例55例,分析其CT轴位及多种重建图像的表现和特点,比较轴位及多种重建图像的优缺点.结果 55例中在轴位上发现瘘口51例,有4例轴位未直接发现瘘口,但在矢状位重建图像上显示清楚,最大密度投影(MIP)、最小密度投影(MinP)、容积重现(VR)及仿支气管镜(VB)等重建对显示瘘口帮助不大;55例中有42例出现严重的肺部感染、食管积气及气管支气管内含气液体等相关征象.结论 通过食管气道瘘的CT直接征象和间接征象可以明确诊断,各种三维后处理技术可以为临床提供一定的信息.

Assessment of CT for esophagotracheal fistula

Objective To explore the CT features of esophagotracheal fistula, and to improve the diagnosis and recognition of esophagotracheal fistula. Methods Clinical and imaging data of 55 cases diagnosed as esophagotrache-al fistula from February 2013 to April 2015 were selected. The performance and characteristics of CT axial view and multiple reconstructed images were analyzed, and the advantages and disadvantages of axial view and multiple recon-struction images were compared. Results Among the 55 cases, 51 cases of orificium fistulae were found in axial view, and 4 cases were not found directly in axial view but in the sagittal reconstruction image. The maximal intensity projec-tion (MIP), minimum intensity projection (MinP), volume rendering (VR) and the virtual bronchoscopy (VB) had little contribution for displaying the orificium fistulae. Among 55 cases, 42 cases had severe pulmonary infection, esophageal gas, and gas or liquid in trachea and bronchu. Conclusion Direct and indirect signs of CT can definitely diagnose esophagotracheal fistula, and the three-dimensional post processing technique can provide further information for the clinical treatment.