Multi-slice CT diagnosis of esophageal atresia and tracheoesophageal fistula in neonates

Objective: To assess the value of multi-slice CT (MSCT) for diagnosing esophageal atresia and tracheoesophageal fistula(EA-TEF) in neonates. Methods: Twenty-six neonates with suspected EA and TEF underwent MSCT with multiplanar reconstruction (MPR) and three-dimensional transparency lung volume rendering (TLVR). The MSCT features were compared with the surgical findings using paired-samples t test and Spearman correlation analysis. Results: Using Gross classification of EA-TEF, the CT diagnosis was type II (1), IIIa (6), IIIb (18), and IV (1). The distances between the proximal and distal esophageal pouches were 2.5-60.0 mm with mean of 11.8 mm on the MPR images and 3.0-23.7 mm with mean of 10.5 mm on TLVR images. Both correlated well with the surgical findings (rMPR = 0.964, rTLVR = 0.952, P < 0.05). MPR was better than TLVR for demonstrating the fistulae when the fistulae were smaller than 1.1 mm. Conclusions: MSCT is valuable in diagnosing, classifying and demonstrating fistula of EA-TEF for surgical planning. (authors)