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Pre- and post-operative visualization of neonatal esophageal atresia/tracheoesophageal fistula via magnetic resonance imaging

Higano, Nara S. (Center for Pulmonary Imaging Research, Imaging Research Center and Department of Pulmonary Medicine, Cincinnati Children's Hospital, OH, 45229, USA ) ; Bates, Alister J. (Center for Pulmonary Imaging Research, Imaging Research Center and Department of Pulmonary Medicine, Cincinnati Children's Hospital, OH, 45229, USA ) ; Tkach, Jean A. (Department of Radiology, Cincinnati Children's Hospital, OH, 45229, USA ) ; Fleck, Robert J. (Upper Airway Center, Cincinnati Children's Hospital, OH, 45229, USA ) ; Lim, Foong Y. (Divisions of Pediatric General, Thoracic, and Fetal Surgery, Cincinnati Children's Hospital, OH, 45229, USA ) ; Woods, Jason C. (Center for Pulmonary Imaging Research, Imaging Research Center and Department of Pulmonary Medicine, Cincinnati Children's Hospital, OH, 45229, USA ) ; Kingma, Paul S. (Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital, OH, 45229, USA ) ;
  • 초록  

    Abstract Esophageal atresia (EA) is a relatively uncommon congenital anomaly, often observed in conjunction with tracheoesophageal fistula (TEF). Surgical repair in neonates typically takes place with little information about the pre-existing EA/TEF structure because there are currently no acceptable tools for evaluating EA/TEF anatomy prior to repair; chest x-ray radiograph does not identify malformation sub-type or gap length, while x-ray computed tomography (CT) demonstrates an unacceptably high exposure to ionizing radiation. There is a need for safe imaging methods to evaluate pre-operative EA/TEF anatomy, which would add value in surgical planning; this need may be met with high-resolution structural MRI. We report three cases of Type-C EA/TEF in neonates. Patients were imaged prior to surgical repair using high-resolution ultrashort echo time (UTE) magnetic resonance imaging (MRI) to visualize tracheoesophageal anatomy and allow for informed surgical planning and risk management. One of the three patients was imaged post-repair to evaluate surgical efficacy and evolution of the tracheoesophageal anatomy. Highlights Esophageal atresia/tracheal esophageal fistula is a rare congenital anomaly. Structural MRI allows for improved surgical planning and parental counseling. Detailed anatomical MRI may identify infants at risk for EA/TEF complications. UTE MRI provides high-quality images without sedation or ionizing radiation.


  • 주제어

    Esophageal atresia .   Tracheoesophageal fistula .   Neonatal MRI .   Surgical planning.  

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