多层螺旋CT在新生儿先天性食管闭锁及气管食管瘘中的初步应用

目的 初步评估MSCT对于先天性食管闭锁及气管食管瘘的诊断价值.方法 对20例经食管造影诊断为食管闭锁及远端气管食管瘘的新生儿进行了64层MSCT扫描,图像后处理使用MinIP的多平面体积重组(MPVR)和胸部透明肺(TL)的VR(TL-VR)模式.影像表现与术中所见进行比较.对数据进行配对t检验及Pearson直线相关分析.结果 CT全部显示出了远端食管的解剖形态.对于远近两盲端食管间的距离,MPVR显示为0.15～3.10 cm(中位数0.70 cm);TL-VR显示为0.10～3.10 cm(中位数0.82 cm);两者差异无统计学意义(t=0.761,P>0.05),且均与术中所见密切相关(r均为0.87,P<0.01).MPVR显示瘘管13例,其中仅4例TL-VR可显示瘘管.结论 MSCT对于先天性食管闭锁及气管食管瘘的术前评估有很高价值,可显示远端食管、评估闭锁食管两盲端的距离以及显示瘘管.

Clinical application of multi-slice CT for congenital esophageal atresia and tracheoesophageal fistula in neonates: initial experience

Objective To assess the clinical value of MSCT in congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) of newborns. Methods Twenty neonates (17 boys and 3 girls) with a mean age of 4.6 days (1 day to 16 days) diagnosed EA and distal TEF underwent MSCT, and multiple planar volume reconstruction (MPVR) and three-dimensional transparency lung volume rendering (TL-VR) imaging were used. The initial diagnosis was made on esophagram by showing the catheter into a blind-ended esophageal pouch. The MSCT manifestations were compared with the surgical findings. Statistical analysis was performed by using SPSS 10.0. Paired-Samples t test and Pearson correlation analysis were used. Results MSCT clearly showed the distal esophageal pouches in all EA patients. The distance between the proximal and distal esophageal pouches determined by MPVR (0.15--3.10 cm, median 0.70 cm) and TL-VR (0.10--3.10 cm, median 0.82 cm) had no remarkable differences and correlated well with the surgical findings (r=0.87, P<0.01). MPVR revealed the orifice of the fistula in 13 TEF cases, while TL-VR only in 4. Conclusion MSCT is an useful and noninvasive imaging method for demonstrating congenital EA and distal TEF, and is highly valuable for surgical planning.