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目的探讨16层螺旋CT直接矢状位、冠状位扫描在新生儿食管闭锁并食管气管瘘(CEA-TEF,congenital esophageal atresia and tracheoesophageal fistula)的应用价值,并对比其与食管造影的结果。方法9例食管闭锁新生儿,行纵隔螺旋CT矢状位或冠状位扫描,测量闭锁盲端距离,观察有无食管气管瘘,并与食管造影、手术结果对照。结果所有病例均获得满意的矢状位或冠状位CT图像。闭锁食管的上下段盲端及瘘管显示清楚。按照Gross分型,9例均为Ⅲ型。两盲端之间的距离为0.6～2.4cm。所有数据与手术结果基本相符,而食管造影不能显示食管下段的情况。结论16层螺旋CT直接矢状位或冠状位扫描扫描范围窄、辐射剂量低,结合多平面重组等后处理方法能准确显示闭锁食管盲端位置及合并食管气管瘘等情况,是新生儿CEA-TEF的一种重要检查手段。
Objective To investigate the value of 16-slice spiral CT direct sagittal and coronal scan in neonatal esophageal atresia and tracheoesophageal fistula (CEA-TEF) and to compare the results with esophageal angiography. Methods Nine neonates with esophageal atresia were examined by mediastinum scan or coronal scan. The distance between the blind end and the esophageal tracheal fistula was measured. The results of esophageal angiography and surgery were compared. Results All cases were satisfactory sagittal or coronal CT images. Closed upper and lower esophageal blind end and fistula shows clearly. According to Gross classification, 9 cases were type Ⅲ. The distance between the two blind ends is 0.6 ~ 2.4cm. All data are consistent with the surgical results, while esophageal angiography can not show the lower esophagus. Conclusion 16-slice spiral CT direct sagittal or coronal scanning scan range is narrow, low radiation dose, combined with multi-plane reconstruction and other post-processing methods can accurately show the location of the closed esophageal blind end and the merger of esophageal tracheal fistula and other neonatal CEA- TEF an important means of inspection.