MSCT在新生儿食管闭锁及气管食管瘘诊断中的应用  

Application of MSCT in the diagnosis of neonatal esophageal atresia and tracheoesophageal fistula

作　　者：戴李华 黄华驰 马慧[1] 黄卫保 王映飞[1] 王万芝 DAI Lihua;HUANG Huachi;MA Hui;HUANG Weibao;WANG Yingfei;WANG Wanzhi(Department of Radiology,The Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区妇幼保健院放射科,广西南宁530021

出　　处：《医学影像学杂志》2023年第12期2215-2219,共5页Journal of Medical Imaging

基　　金：广西壮族自治区卫生健康委员会科研课题项目(编号:Z20200755)。

摘　　要：目的探讨MSCT在新生儿食管闭锁及气管食管瘘诊断中的应用价值。方法选取在我院就诊的48例食管闭锁患者MSCT图像,采用MPR、MinIP、VR等方法对原始图像进行重建,对食管闭锁及气管食管瘘情况进行观察。对MSCT与术中判断Gross分型、Ⅲ型病例瘘口位置的符合程度进行Kappa一致性分析,对MSCT所测Ⅲ型食管闭锁两盲端间距与术中所见进行比较,对MSCT诊断与术中所见进行相关性分析。结果48例食管闭锁患者中,MSCT判断Gross分型准确率为89.6%(43/48),MSCT与术中分型存在较强一致性(Kappa=0.774,P<0.001)。46例Ⅲ型食管闭锁患者中,MSCT判断瘘口位置的准确率为82.6%(38/46),MSCT与术中对瘘口位置的判断存在中等一致性(Kappa=0.480,P<0.001)。MSCT所测Ⅲ型食管闭锁两盲端间距与术中所见比较差异无统计学意义(P>0.05)。食管闭锁MSCT分型与术中分型存在较高正相关(r=0.786,P<0.001),MSCT对Ⅲ型病例瘘口位置判断与术中所见存在中度正相关(r=0.558,P<0.001),MSCT所测Ⅲ型食管闭锁两盲端间距与术中所见存在较高正相关(r=0.739,P<0.001)。结论MSCT在食管闭锁的诊断中具有较大的优势,可为临床制订治疗计划提供重要参考依据。Objective To investigate the application value of MSCT in the diagnosis of neonatal esophageal atresia and tra⁃cheoesophageal fistula.Methods The MSCT images of 48 patients with esophageal atresia who were treated in our hospital were collected,the original images were reconstructed by MPR,MinIP and VR and the conditions of esophageal atresia and tracheo⁃esophageal fistula were observed.Kappa consistency analysis was performed on the degree of conformity between MSCT and intra⁃operative judging of Gross classification and typeⅢfistula location,and the distance between the two blind ends of typeⅢesophageal atresia measured by MSCT was compared with intraoperative findings.Correlation analysis was performed on MSCT and intraoperative findings.Results Among the 48 patients with esophageal atresia,the accuracy rate of MSCT in judging Gross classification was 89.6%(43/48),and there was relatively strong consistency between MSCT and intraoperative classification(Kappa=0.774,P<0.001).Among the 46 patients with type III esophageal atresia,the accuracy rate of MSCT in judging the loca⁃tion of the fistula was 82.6%(38/46),and there was moderate consistency between MSCT and intraoperative judgment on the lo⁃cation of the fistula(Kappa=0.480,P<0.001).There was no significant difference in the distance between the two blind ends of type III esophageal atresia measured by MSCT compared with the intraoperative findings(P>0.05).There was a relatively high positive correlation between MSCT classification of esophageal atresia and intraoperative classification(r=0.786,P<0.001),and there was a moderate positive correlation between MSCT in judging the location of fistula in type III cases and intraoperative find⁃ings(r=0.558,P<0.001),there was a relatively high positive correlation between the distance between the two blind ends of type III esophageal atresia measured by MSCT and the intraoperative findings(r=0.739,P<0.001).Conclusion MSCT has great ad⁃vantages in the diagnosis of esophageal atresia and can provide

关 键 词：新生儿 食管闭锁 气管食管瘘 体层摄影术 X线计算机 

分 类 号：R722.1[医药卫生—儿科] R814.42[医药卫生—临床医学]