Three-Dimensional CT of Congenital Esophageal Atresia and Distal Tracheoesophageal Fistula in Neonates
Preliminary Results
Suat Fitoz1,
Çetin Atasoy1,
Aydin Yagmurlu2,
Serdar Akyar1,
Ay
e Erden1 and
Hüseyin Dindar2
1
Department of Radiology, University of Ankara, School of Medicine, Talatpasa
Bulvari, 06100 Sihhiye/Ankara, Turkey.
2
Department of Pediatric Surgery, University of Ankara, School of Medicine,
06100 Dikimevi/Ankara, Turkey.
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Fig. 1A. —32-week-old preterm male infant at first postnatal day.
Virtual bronchoscopic image shows motion artifact obscuring visualization of
distal trachea.
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Fig. 1B. —32-week-old preterm male infant at first postnatal day. At
level below artifact orifice of distal fistula (arrow) is clearly
shown.
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Fig. 1C. —32-week-old preterm male infant at first postnatal day.
Coronal reformatted image shows respiratory and motion artifacts as cause of
deterioration in virtual bronchoscopy.
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Fig. 2A. —4-day-old dyspneic female neonate with aspiration pneumonia.
Shaded-surface—display image of mediastinum from left lateral aspect
(after left lung was removed from image) reveals significant dilatation of
proximal esophageal pouch (E). Note narrow calibrated distal esophageal
segment (arrow). Tracheal connection cannot be seen because of
peristalsis.
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Fig. 2B. —4-day-old dyspneic female neonate with aspiration pneumonia.
Virtual bronchoscopic image reveals orifice of fistula as small depression
(arrow).
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Fig. 3A. —34-week-old preterm female infant at 4th day after birth who
presented with inability to swallow. Three-dimensional surface-rendered
anteroinferior image depicts complex anatomic malformation. Note proximal
atretic portion of esophagus (black arrow) and distal segment arising
from carina (white arrow).
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Fig. 3B. —34-week-old preterm female infant at 4th day after birth who
presented with inability to swallow. Three-dimensional surface-rendered image
from posterior external view of trachea and large airways shows lesion better
defined as fistulous connection with distal esophagus at posterior wall of
carina.
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Fig. 3C. —34-week-old preterm female infant at 4th day after birth who
presented with inability to swallow. Virtual bronchoscopic image of carina
clearly shows orifice of fistula (thick arrow) posterior to orifices
of main bronchi (thin arrows).
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Fig. 4A. —33-week-old premature female infant with feeding difficulty.
Shaded-surface—display image shows long gap between proximal pouch
(double arrowhead) and distal fistula (thick arrow). Note
distortion caused by catheter inserted into malacic segment of trachea. Thin
arrow indicates tip of catheter.
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Fig. 4B. —33-week-old premature female infant with feeding difficulty.
Virtual bronchoscopic image shows posteriorly located small orifice of fistula
(arrow) at level of carina.
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Fig. 5A. —33-week-old premature male infant with esophageal atresia.
Shaded-surface—display image clearly delineates anatomy of proximal
pouch and shows fistula between carina and distal esophagus (black
arrow). Note also proximal tracheomalacia (thin white arrows)
and artifactual interruption of left main bronchus (thick white
arrow).
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Fig. 5B. —33-week-old premature male infant with esophageal atresia.
Virtual bronchoscopic image shows tracheal opening of fistula (arrow)
between orifices of main bronchi.
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Copyright © 2000 by the American Roentgen Ray Society.
