Satinder Pal Singh MD, Presenter: Nothing to Disclose

1) To discuss the expanding role of MDCT in evaluation of adult CHD with several illustrative cases. CT provides excellent anatomic information about intra and extra cardiac anomalies and any complications related to palliative or corrective surgery done in early childhood. Retrospective gated CT is also helpful in evaluation of right ventricle function especially in the presence of hardware.

Advances in surgical technique and perioperative care have significantly improved the success rate and life expectancy in congenital heart disease (CHD). Echocardiography remains the primary imaging method though it can be limited by lack of adequate acoustic windows and suboptimal depiction of the extra cardiac vasculature, which can be important in the postoperative evaluation.  Multidetector computed tomography (MDCT), because of wide availability, short acquisition time, high spatial resolution, improved temporal resolution and isotropic imaging, is an attractive alternative method. The radiation exposure from CT can be limited by choosing appropriate protocol based on the clinical question and use of lower kVp, mAs, iterative reconstruction, high pitch imaging and limiting FOV to the desired anatomy. MDCT is playing an increasingly important role in the postoperative imaging and surveillance of patients with congenital heart disease with its unique capabilities to characterize anomalies and complications that may be difficult to evaluate with other technique. CT provides objective and accurate morphologic and functional information and is very useful for detecting extracardiac abnormalities. When performed with ECG-gating, CT provides useful information about coronary arteries, valves, complex cardiac morphology, and cardiac function, especially in patients with previous surgery, the details of which are unknown. A thorough understanding of the normal anatomy, morphologic features of congenital heart diseases, knowledge of the details of surgical procedures and their complications are essential for choosing optimal CT protocol and accurate CT interpretation.. A sequential segmental approach should be used in evaluating morphologic features, during the review of CT images obtained in patients with congenital cardiac defects and in postoperative adult patients.

Singh, S, Evaluation of Adult Congenital Heart Disease with CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000962.html