Diagnostic accuracy of ultrasonography for the prenatal diagnosis of esophageal atresia and tracheoesophageal fistula

Wang,Cong; Ning,Xiaofei; Duan,Yangcan; Zhang,Zhonglu; Wang,Shaochun

doi:10.3892/etm.2021.10075

June-2021 Volume 21 Issue 6

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

June-2021 Volume 21 Issue 6

Full Size Image

Article Open Access

Diagnostic accuracy of ultrasonography for the prenatal diagnosis of esophageal atresia and tracheoesophageal fistula

Authors:
- Cong Wang
- Xiaofei Ning
- Yangcan Duan
- Zhonglu Zhang
- Shaochun Wang
View Affiliations / Copyright

Affiliations: Department of Ultrasonography, Affiliated Hospital of Jining Medical University, Jining, Shandong 272000, P.R. China, Department of Gastrointestinal Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272000, P.R. China

Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 643
|
Published online on: April 18, 2021

https://doi.org/10.3892/etm.2021.10075
Expand metrics +

Abstract

Ultrasound is recommended as a first‑line requirement prior to MRI or amniotic fluid analysis, which have high diagnostic accuracy for esophageal atresia (EA). Therefore, the aim of the present prospective study was to evaluate the accuracy of high‑performance ultrasound for the prenatal examination of EA/tracheoesophageal fistula (TOF). In total, 64 pregnant women with fetuses suspected of having EA/TOF participated in the study. The gestational age of the fetuses ranged between 16 and 40 weeks, with a mean of 26.33±3.57 weeks. Ultrasound images of the esophagus and trachea on parasternal and para‑aortic axis longitudinal and transverse sections were compared with the results of standard postnatal diagnostic tests. Sensitivity and specificity values were determined and a receiver operating characteristic (ROC) curve was generated. Among all the fetuses screened, 16 were suspected of having EA/TOF during the prenatal ultrasonography. In postnatal examinations, 34 cases of EA/TOF were confirmed, corresponding to an EA/TOF incidence of 53.2% (95% CI, 40.2‑65.7%). The area under the ROC curve (AUC) was lower for prenatal ultrasonography compared with postnatal diagnostic tests (AUC=0.55; 95% CI, 0.44‑0.65). Considering postnatal examination as the gold standard, prenatal ultrasonography had a sensitivity of 29.4% (95% CI, 15.1‑47.5%) and a specificity of 80% (95% CI, 61.4‑92.3%) for the diagnosis of EA/TOF. In addition, the positive predictive value was 62.5% (95% CI, 35.4‑82.8%), the negative predictive value was 50% (95% CI, 35.2‑64.8%), the positive likelihood ratio was 1.47 (95% CI, 0.61‑3.56) and the negative likelihood ratio was 0.88 (95% CI, 0.67‑1.17). The results of the present study indicate that preoperative ultrasound has poor sensitivity but very good specificity for the diagnosis of EA/TOF. The use of ultrasound alone would result in a high rate of a false‑positive diagnoses. However, prenatal ultrasonography may be useful as a preliminary screening tool to exclude patients for suspected EA/TOF.

View Figures

View References

1	Marseglia L, Manti S, D'Angelo G, Gitto E, Salpietro C, Centorrino A, Scalfari G, Santoro G, Impellizzeri P and Romeo C: Gastroesophageal reflux and congenital gastrointestinal malformations. World J Gastroenterol. 21:8508–8515. 2015.PubMed/NCBI View Article : Google Scholar
2	Pinheiro PFM, Simões e Silva AC and Pereira RM: Current knowledge on esophageal atresia. World J Gastroenterol. 18:3662–3672. 2012.PubMed/NCBI View Article : Google Scholar
3	Nassar N, Leoncini E, Amar E, Arteaga-Vázquez J, Bakker MK, Bower C, Canfield MA, Castilla EE, Cocchi G, Correa A, et al: Prevalence of esophageal atresia among 18 international birth defects surveillance programs. Birth Defects Res A Clin Mol Teratol. 94:893–899. 2012.PubMed/NCBI View Article : Google Scholar
4	Tandon RK, Sharma S, Sinha SK, Rashid KA, Dube R, Kureel SN, Wakhlu A and Rawat JD: Esophageal atresia: Factors influencing survival-experience at an Indian tertiary centre. J Indian Assoc Pediatr Surg. 13:2–6. 2008.PubMed/NCBI View Article : Google Scholar
5	Seo J, Kim DY, Kim AR, Kim DY, Kim SC, Kim IK, Kim KS, Yoon CH and Pi SY: An 18-year experience of tracheoesophageal fistula and esophageal atresia. Korean J Pediatr. 53:705–710. 2010.PubMed/NCBI View Article : Google Scholar
6	Valevičienė NR, Varytė G, Zakarevičienė J, Kontrimavičiūtė E, Ramašauskaitė D and Rutkauskaitė-Valančienė D: Use of magnetic resonance imaging in evaluating fetal brain and abdomen malformations during pregnancy. Medicina (Kaunas). 55(55)2019.PubMed/NCBI View Article : Google Scholar
7	Pardy C, D'Antonio F, Khalil A and Giuliani S: Prenatal detection of esophageal atresia: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 98:689–699. 2019.PubMed/NCBI View Article : Google Scholar
8	Spitz L: Esophageal atresia. Lessons I have learned in a 40-year experience. J Pediatr Surg. 41:1635–1640. 2006.PubMed/NCBI View Article : Google Scholar
9	Hands LJ and Dudley NE: A comparison between gap-length and Waterston classification as guides to mortality and morbidity after surgery for esophageal atresia. J Pediatr Surg. 21:404–406. 1986.PubMed/NCBI View Article : Google Scholar
10	Bradshaw CJ, Thakkar H, Knutzen L, Marsh R, Pacilli M, Impey L and Lakhoo K: Accuracy of prenatal detection of tracheoesophageal fistula and oesophageal atresia. J Pediatr Surg. 51:1268–1272. 2016.PubMed/NCBI View Article : Google Scholar
11	Su P, Yuan Y, Zhang Z, Huang Y and Wang W: Application of high-frequency ultrasound in esophageal atresia with distal fistula. Dis Esophagus. 27:325–329. 2014.PubMed/NCBI View Article : Google Scholar
12	Langer J, Hussain H, Khan A, Minkes R, Gray D, Siegel M and Ryan G: Prenatal diagnosis of esophageal atresia using sonography and magnetic resonance imaging. J Pediatr Surg. 36:804–807. 2001.PubMed/NCBI View Article : Google Scholar
13	Spaggiari E, Faure G, Rousseau V, Sonigo P, Millischer-Bellaiche AE, Kermorvant-Duchemin E, Muller F, Czerkiewicz I, Ville Y and Salomon LJ: Performance of prenatal diagnosis in esophageal atresia. Prenat Diagn. 35:888–893. 2015.PubMed/NCBI View Article : Google Scholar
14	Choudhry M, Boyd PA, Chamberlain PF and Lakhoo K: Prenatal diagnosis of tracheo-oesophageal fistula and oesophageal atresia. Prenat Diagn. 27:608–610. 2007.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Diagnostic accuracy of ultrasonography for the prenatal diagnosis of esophageal atresia and tracheoesophageal fistula

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Related Articles