The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States.
The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States.
J Med Imaging Radiat Sci. 2021 Nov;52(3S):S88-S109. doi: 10.1016/j.jmir.2021.08.008. Epub 2021 Sep 2.
Due to advances in cardiac surgery, perioperative care and transcatheter interventions, the majority of infants with congenital heart disease (CHD) now survive and reach adulthood. Transthoracic Echocardiography (TTE) is considered the primary imaging modality in evaluation of patients with CHD. However, in adults it can be limited due to several reasons. Although cardiac magnetic resonance (CMR) is extremely useful in evaluating cardiac morphology and function, it is not widely available, takes a long time to obtain images, and cannot be done in severely ill patients or patients that have claustrophobia. Due to high spatial and temporal resolution, isotropic imaging fast imaging and wide availability, multidetector computed tomography (MDCT) has emerged as an excellent alternative modality in the evaluation of adult congenital heart disease (ACHD). It can be performed on patients with hardware and those with claustrophobia, due to shorter image acquisition time. In this article, the commonly encountered congenital heart disorders in adults are reviewed, whether incidentally discovered on a computed tomography (CT), on a CT done to evaluate sequela of unknown CHD, or known treated CHD. To appropriately perform and evaluate CT imaging for postoperative correction or palliation congenital heart disease in adults, the imager should know the detailed cardiac anatomy, details of the operative technique used, and be familiar with the common short and long term post-operative complications.
由于心脏外科学、围手术期护理和经导管介入技术的进步，大多数先天性心脏病（CHD）患儿现在能够存活并进入成年期。经胸超声心动图（TTE）被认为是评估 CHD 患者的主要影像学检查方法。然而，在成年人中，由于多种原因，它可能会受到限制。虽然心脏磁共振（CMR）在评估心脏形态和功能方面非常有用，但由于其在获取图像方面耗时较长，且不适用于病情严重或患有幽闭恐惧症的患者，因此并未广泛应用。由于具有较高的空间和时间分辨率、各向同性成像、快速成像和广泛的可用性，多层螺旋 CT（MDCT）已成为评估成人先天性心脏病（ACHD）的一种极好的替代方法。它可以在有硬件和幽闭恐惧症的患者中进行，因为采集图像的时间更短。本文回顾了在 CT 检查中偶然发现的、为评估未知 CHD 后遗症或已知治疗过的 CHD 而进行的 CT 检查中常见的成人先天性心脏疾病，并对其进行了评估。为了正确进行和评估成人先天性心脏病术后矫正或姑息治疗的 CT 成像，成像者应了解详细的心脏解剖结构、手术技术的详细信息，并熟悉常见的短期和长期术后并发症。
