MSCT扫描对新生儿食管闭锁、食管气管瘘的诊断价值

Value of MSCT in diagnosis of esophageal atresia and esophagotracheal fistula

目的 探讨多层螺旋CT(MSCT)扫描对新生儿食管闭锁、气管食管瘘的诊断价值。方法 回顾性分析2010-01—2021-12于中国人民解放军联勤保障部队第九八九医院平顶山医疗区经手术确诊的70例新生儿食管闭锁、气管食管瘘的临床资料。比较术前MSCT扫描Gross分型、瘘口位置、瘘管管径,以及闭锁近、远端食管盲端距离与术中探查结果的一致性。结果 70例患儿术中探查结果为:GrossⅠ型0例,Ⅱ型0例,Ⅲa型12例,Ⅲb型55例,Ⅳ型0例,Ⅴ型3例;瘘口位置分别为气管下段51例,气管分叉处15例,左侧主支气管起始处4例。术前MSCT扫描与术中探查的一致性好,Kappa值分别为0.889、0.867(P<0.05)。术前MSCT扫描与术中探查的瘘管管径和闭锁近、远端食管盲端的距离差异无统计学意义(P>0.05)。结论 MSCT扫描对新生儿食管闭锁、气管食管瘘的分型、瘘口位置、瘘管管径,以及闭锁近、远端食管盲端的距离与术中探查结果的一致性较高,可为术前制订手术方案提供参考。

Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT) in esophageal atresia and esophagotracheal fistula.Methods The clinical data of 70 newborns with esophageal atresia complicated with tracheoesophageal fistula were retrospectively analyzed between January 2010 and December 2021. All the infants underwent MSCT scanning, and the consistency between MSCT scanning and surgical results was compared. Results The results of gross classification of 70 cases included 0 case of type I,There were 0 case of type Ⅱ, 12 cases of type Ⅲ a, 55 cases of type Ⅲ B, 0 case of type IV and 3 cases of type V. the kappa value of MSCT was 0.889, with good consistency(P<0.05);There were 51 cases in the lower segment of the trachea, 15 cases at the bifurcation of the trachea, and 4 cases at the beginning of the left main bronchus. The kappa value of MSCT was 0.867, and the consistency was good(P<0.05);There was no significant difference in the diameter of fistula and the distance between proximal and distal esophageal blind end between MSCT and surgery(P>0.05).Conclusion MSCT detection of esophageal atresia and tracheoesophageal fistula classification, fistula opening position and the distance of esophageal atresia blind end showed high consistency with surgical results.