Multidetector-row computed tomography three-dimensional volume reformatted 'transparency' images to define an upper pouch fistula in oesophageal atresia

Oesophageal atresia (OA) is an important congenital malformation in which prompt diagnosis and appropriate management can significantly improve outcome. The surgical approach to repair of OA and associated tracheo-oesophageal fistulae (TOF) depends upon correct evaluation of the tracheobronchial tree. Three-dimensional imaging of the tracheobronchial tree using CT data to produce shaded surface displays and virtual bronchoscopy has been reported in paediatric and neonatal patients with OA and TOF and is described as accurate and helpful, non-invasively facilitating the appreciation of complex anatomy prior to surgery. We describe the technique of reconstructing 3D volume-reformatted 'transparency' images using insufflated air as a negative contrast medium. This technique is fast, accurate and produces high-quality images that are easy to reproduce.