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. (authors)