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

• Main Authors: Nara S. Higano, Alister J. Bates, Jean A. Tkach, Robert J. Fleck, Foong Y. Lim, Jason C. Woods, Paul S. Kingma
• Format: Article
• Language: English
• Published: Elsevier 2018-02-01
• Series: Journal of Pediatric Surgery Case Reports
• Subjects: Esophageal atresia; Tracheoesophageal fistula; Neonatal MRI; Surgical planning
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213576617302725

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.