Correlative imaging in congenital heart disease

Abstract

For the evaluation of congenital heart diseases (CHDs), echocardiography is the initial diagnostic modality and Catheter angiography is the gold standard for delineation of the anomalies. Though echocardiography is the initial diagnostic modality in CHDs, it has its limitations and Catheter angiography is relatively invasive and should be reserved for therapeutic procedures. Multidetector computed tomography (MDCT) has emerged as an important tool for cardiac imaging owing to constant advancements in computed tomography scanners. With the judicious and innovative use of three-dimensional reconstructions, the depiction of congenital anomalies is more accurate and it is possible to perform a virtual surgery to aid the surgeon in planning the approach to the patient as a one or two step procedure, counseling the parents about the outcome and giving a fair estimate of the cost of treatment. MDCT acts as a one stop shop for a complete evaluation of the cardiac, extra-cardiac, visceral and skeletal anomalies; their combinations and subsequent effects on each other. Excellent delineation of the vascular compressions on the tracheo-bronchial tree, degree of main and branch pulmonary artery stenosis, anomalous drainage of pulmonary and systemic veins, interruptions and narrowing of the aorta, anomalies of origin and course of coronary arteries are unique to MDCT.