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Esophageal Atresia and Tracheal Stenosis

Use of Three-Dimensional CT and Virtual Bronchoscopy in Neonates, Infants, and Children

¹ Department of Radiology, Queen Mary Hospital, 102 Pokfulam Rd., Hong Kong, China
² Department of Surgery, Division of Paediatric Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.

View larger version (98K): [in a new window]   Fig. 1A. —2-day-old female neonate with type-1 short-gap esophageal atresia Three-dimensional CT scan shows upper esophagus (UE), fistula (black arrow), and distal esophageal segment (LE). Distal portion of lower esophageal segment is not shown. Distance between upper and lower esophageal segments is indicated by white arrows and is less than 2 cm.

View larger version (115K): [in a new window]   Fig. 1B. —2-day-old female neonate with type-1 short-gap esophageal atresia Virtual bronchoscopic image shows fistula at posterior aspect of carina (arrow).

View larger version (43K): [in a new window]   Fig. 2A. —1-year-old male infant with tracheal stenosis. Three-dimensional CT scan shows long-segment funnellike tracheal stenosis down to carina.

View larger version (96K): [in a new window]   Fig. 2B. —1-year-old male infant with tracheal stenosis. Virtual bronchoscopic image shows stenotic lumen (arrow).

View larger version (111K): [in a new window]   Fig. 2C. —1-year-old male infant with tracheal stenosis. Virtual bronchoscopic image extending beyond stenotic portion shows normal carina.

View larger version (98K): [in a new window]   Fig. 3A. —5-month-old male infant with tracheal bronchus. Three-dimensional CT scan shows right upper lobe bronchus (arrow) arises directly from trachea. Stenosis is seen at distal portion of trachea (T), carina (C), and origins of right (R) and left (L) main bronchi. Carina is located in normal position—that is, not lower than T5 level on axial images (not shown).

View larger version (87K): [in a new window]   Fig. 3B. —5-month-old male infant with tracheal bronchus. Virtual bronchoscopic image shows large rightsided lumen and small left-sided lumen. Right-sided lumen (thin arrow) is aberrant right upper lobe bronchus. Left-sided lumen (thick arrow) is stenotic trachea.

View larger version (132K): [in a new window]   Fig. 3C. —5-month-old male infant with tracheal bronchus. Virtual bronchoscopic image shows stenotic carina and right (thin arrow) and left (thick arrow) main bronchi. Because camera of virtual bronchoscope is angled toward right side, left main bronchus appears to be more narrow than that of right side.

View larger version (85K): [in a new window]   Fig. 4A. —2-year-old male infant with poststenting of tracheal stenosis Three-dimensional CT scan shows normal-caliber trachea with stent in situ.

View larger version (133K): [in a new window]   Fig. 4B. —2-year-old male infant with poststenting of tracheal stenosis Virtual bronchoscopic image shows patent lumen with indentations of tracheal mucosa between stent.

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