MSCT及后处理技术诊断食管闭锁并气管食管瘘

目的探讨MSCT及后处理技术诊断先天性食管闭锁合并气管食管瘘(EA-TEF)的价值。方法收集8例临床疑诊为EA-TEF的新生儿,于手术前行食管造影及MSCT扫描并进行重建,重建方法包括MPR、MinIP、VR等;将术前MSCT诊断结果与手术结果进行对照研究。结果 8例中,1例为EA-TEFⅠ型,7例为Ⅲ型(其中Ⅲa型4例,Ⅲb型3例);5例伴有其他先天性畸形。利用MPR、VR重建图像测得的闭锁食管上下盲端的距离与手术结果基本相符,7例仿真内镜图像能明确显示瘘管开口。结论 MSCT及其后处理技术可以准确诊断EA-TEF并进行分型,显示闭锁食管上下盲端情况及气管-食管瘘口位置可靠,还能显示肺部病变及其他伴随畸形。

MSCT and image reconstruction techniques in diagnosis of esophageal atresia complicated with tracheoesophageal fistula

Objective To explore the value of MSCT in the diagnosis of congenital esophageal atresia and tracheoesophageal fistula（EA-TEF）.Methods Eight potential EA-TEF neonates were collected and underwent upper gastrointestinal contrast examination and MSCT before operation.The reconstructed methods included MPR,MinIP,VR and so on.Then the preoperative results of MSCT were compared with the finding of surgical operation.Results There was 1 case of type I and 7 cases of type Ⅲ EA-TEF（including 4 type Ⅲa and 3 type Ⅲb）.Other congenital malformations were detected in 5 cases.The distance between the two caeca measured on MPR and VR images was agreed with the results of the operation.The fistulas of 7 cases type Ⅲ EA-TEF were clearly manifested on VE.Conclusion MSCT and reconstruction techniques have great value on the diagnosing and typing of EA-TEF,and can measure the distance between the two caeca and show the fistula accurately.Besides,it is helpful to evaluation on lung condition and related malformations.