The value of helical CT and its postprocessing technique in the diagnosis of congenital esophageal atresia and tracheoesophageal fistula

Objective To evaluate the diagnostic value of helical CT in congenital esophageal atresia and tracheoesophageal fistula (CEA-TEF). Methods Chest radiography, catheter insertion into upper esophagus, and double-detector row CT scanning were performed in 6 neonates with clinically suspected CEA-TEF preoperatively. Then multi-plane reconstruction (MPR), three-dimensional CT, and virtual bronchoscopy were made on the workstation. The imaging manifestations were correlated with the surgical findings. Results According to Gross classification, five cases were type-Ⅲ and one was type-Ⅰesophageal atresia. All the MPR and three-dimensional CT imaging findings corresponded to the surgical findings. Virtual bronchoscopy images revealed the orifice of the fistula in five cases. Conclusion MPR, three-dimensional CT, and virtual bronchoscopy are reliable techniques for showing and assessing the distance between the two esophageal pouches, the presence and absence of fistula, and position of fistula in CEA-TEF. Helical CT can afford the reliable evidence in the preoperative assessment of CEA-TEF and accurate establishment of surgical plan.