Abstract Objective: To assess the diagnostic value of axial combined with multi window technique and curved planar reformation(CPR) for esophageal fistula. Methods: A retrospective analysis was based on data collected from 110 patients for suspected esophageal fistula from October 2010 to October 2016. All patients underwent MDCT axial, multi window parameters and CPR. The chi-square test was used to compare differences of the results of esophageal fistula, fistula position diagnosed by axial combined with multi window technique and CPR. Taking the results of endoscopy, or follow-up as the standard, the diagnostic value of axial combined with multi window technique and CPR, axial were analyzed and compared by ROC. Wilcoxon test was used to examine the difference of the length of the fistula examined by MDCT and endoscopy. Results: Among these 110 patients of suspected esophageal fistula, a total of 53 patients(55 fistulas) were diagnosed using endoscopy and 1 patient had 3 fistulas. The efficiency of axial combined with multiple window technique and CPR in the diagnosis of esophageal fistula was higher than that of axial, the difference was statistically significant(χ2=8.787, P=0.032), which was no difference for fistula position(χ2=0.104, P>0.05). Compared with the length of fistula using endoscopy, significant difference was observed using CPR fat window(z=-2.722, P=0.006). There was no significant difference using CPR mediastinal window(z= -1.807, P=0.071). Conclusion: Axial combined with multi window technique and CPR has unique value in the diagnosis of esophageal fistula, which can evaluate the position and range of the fistula, and improve the accuracy of diagnosis.
LIU Cai-yun,MIAO Xin-zhong,SHA Zheng-bu, et al. The value of MDCT combined with multi window parameters and #br#
curved planar reformation in diagnosis of esophageal fistula[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(10): 722-726.
[1]Chirica M, Champault A, Dray X, et al. Esophageal perforations[J]. J Visc Surg, 2010, 147(3): e117-e128.
[2]陈均,吴青山,陆锦贵. 多层螺旋CT多平面重组诊断食管裂孔疝的价值[J]. 中国临床医学影像杂志,2014,25(11):816-819.
[3]周晖,陈胜喜,刘进康,等. MSCT碘水造影结合三维重建诊断食管癌术后胸胃瘘[J]. 中国医学影像技术,2013,29(6):949-952.
[4]兰国宾,历严明,戴士林,等. 标准肺窗、腹窗、脂肪窗在胃肠道穿孔气腹征中诊断价值的对比分析及在软读片中的作用[J]. 临床放射学杂志,2015,34(6):1007-1009.
[5]Zhou WZ, Song HY, Park JH, et al. Full-thickness esophageal perforation after fluoroscopic balloon dilation: incidence and management in 820 adult patients[J]. Am J Roentgenol, 2015, 204(5): 1115-1119.
[6]Pugmire BS, Lim R, Avery LL. Review of Ingested and Aspirated Foreign Bodies in Children and Their Clinical Significance for Radiologists[J]. Radiographics, 2015, 35(5): 1528-1538.
[7]Oguma J, Ozawa S. Idiopathic and Iatrogenic Esophageal Rupture[J]. Kyobu Geka, 2015, 68(8): 701-705.
[8]Nishikawa Y, Miyamoto S, Horimatsu T, et al. Esophageal Rupture Associated with Colonoscopy Preparation[J]. J Am Geriatr Soc, 2016, 64(3): 682-683.
[9]Harman F, Kaptanoglu E, Hasturk AE. Esophageal perforation after anterior cervical surgery: a review of the literature for over half a century with a demonstrative case and a proposed novel algorithm[J]. Eur Spine J, 2016, 25(7): 2037-2049.
[10]韩新巍,吴刚,赵明,等. 胸腔胃-气道瘘的临床表现与螺旋CT诊断[J]. 世界华人消化杂志,2007,15(8):905-908.
[11]Gupta R, Munoz R. Evaluation and Management of Chest Pain in the Elderly[J]. Emerg Med Clin North Am, 2016, 34(3): 523-542.