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J Pediatr Surg Case Rep. 2018 Feb;29:5-8. doi: 10.1016/j.epsc.2017.10.001. Epub 2017 Oct 3.

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

Author information

1
Center for Pulmonary Imaging Research, Imaging Research Center and Department of Pulmonary Medicine, Cincinnati Children's Hospital, OH 45229 USA.
2
Department of Physics, Washington University in St. Louis, MO 63130, USA.
3
Upper Airway Center, Cincinnati Children's Hospital, OH 45229 USA.
4
Department of Radiology, Cincinnati Children's Hospital, OH 45229 USA.
5
Divisions of Pediatric General, Thoracic, and Fetal Surgery, Cincinnati Children's Hospital, OH 45229 USA.
6
Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital, OH 45229 USA.
7
Cincinnati Fetal Center.

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) demonstrate 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.

KEYWORDS:

esophageal atresia; neonatal MRI; surgical planning; tracheoesophageal fistula

PMID:
29399473
PMCID:
PMC5794017
[Available on 2019-02-01]
DOI:
10.1016/j.epsc.2017.10.001

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