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在EA/Tef修复后患者肌肉骨变形增加和肺体积减少:实时MRI研究

Ophelia Aubert¹, Martin Lacher¹, Steffi Mayer¹

¹Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.

Annals of surgery

|February 8, 2024

概括

接受食道缩 (EA) 修复的儿童经历胸部和肺部发育的减少,特别是在开放性手术后. 实时MRI揭示了胸切除术后显著的肌肉骨变形,突出了改善外科手术方法的需要.

科学领域:

儿科手术儿科手术
胸部成像胸部成像
遗传异常是一种先天性异常.

背景情况:

在儿童中食道缩 (EA) 修复往往导致肌肉骨变形和肺部问题.
实时磁共振成像 (MRI) 提供了一种新的非镇静方法,用于评估儿童自发呼吸期间的胸部结构.

研究的目的:

通过使用胸部实时核磁共振 (MRI) 对食道 (EA) 进行开放式或微创性 (MIS) 修复后进行术后形态和功能胸部变化的评估.
将这些变化与健康儿科对照组的变化进行比较.

主要方法:

使用3特斯拉实时MRI对72名儿童 (3-18岁) 的前性评估.
评估肌肉骨变形,胸部横截面积 (CSAs),肺体积和强迫呼吸期间的动态胸部/肺部运动.

主要成果:

与对照组相比,EA修复的儿童显示胸部CSA和肺体积的右向左比率降低 (P <0.05).
与MIS相比,开放式修复 (胸腔切除术) 与肋骨融合,粘附 (78%) 和脊柱脊椎病 (15%) 的发生率明显更高.
胸切除术数量增加与胸部体积较小相关 (P <0.05).

结论:

动态实时MRI有效地可视化EA修复后的形态和功能变化.
经过EA修复,特别是开放性手术,导致右侧胸部和肺部发育受损,以及显著的肌肉骨疾病.
婴儿胸切除术后肌肉骨问题的高发病率强调了对少入侵的外科手术技术的需求.

关键词:

消化道缩症消化道缩症肺部的发育肺部的发育肌肉骨疾病肌肉骨疾病实时核磁共振成像 (MRI).胸部运动的胸部运动.

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