目的：探讨轴位联合多种窗技术和曲面重组（Curved planar reformation，CPR）诊断食管瘘的价值。方法：回顾性搜集2010年10月—2016年10月期间疑似食管瘘患者110例，所有患者均行MDCT轴位及多种窗技术和CPR成像。利用χ2检验比较轴位联合多种窗技术和CPR诊断食管瘘、确定瘘口位置与轴位诊断结果的差异；以胃镜或随访结果为金标准，采用ROC评价轴位联合多种窗技术和CPR、轴位的诊断效能。利用Wilcoxon检验比较MDCT图像上测量食管瘘口纵向长度与胃镜测量结果的差异。结果：110例可疑食管瘘患者中，食管瘘53例（55处瘘口），均经胃镜、食管造影证实。采用轴位联合多种窗技术和CPR诊断食管瘘效能高于轴位，两者比较有统计学差异，χ2=8.787，P=0.032；但在确定食管瘘口位置方面无统计学差异，χ2=0.104，P＞0.05。CPR脂肪窗测量瘘口长度与胃镜测量结果比较有统计学差异，z=-2.722，P=0.006。CPR纵隔窗上测量结果与胃镜比较无统计学差异，z=-1.807，P=0.071。结论：轴位联合多种窗技术CPR对食管瘘具有独特的诊断价值，可全面评估瘘口部位及范围，提高诊断准确率。

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.