Computed tomography in congenital heart disease.

The CT results in defining anatomic and certain physiologic features in patients with congenital heart and great vessel anomalies were reviewed in 32 patients with a variety of congenital cardiac and aortic arch anomalies. Most of these cases (18 patients) were selected on the basis of angiocardiographic or echocardiographic studies performed prior to the CT evaluation. In 14 patients CT was performed as the initial study. All examinations were contrast enhanced and performed on a third generation CT scanner with scan time of 2 or 4 s. The CT demonstration of abnormalities of the great vessels such as positional anomalies, atresias, and hypoplasias was equivalent to angiocardiography and usually superior to two-dimensional echocardiography. The CT results in 14 patients were sufficient to obviate catheterization and angiography; most of these cases were abnormalities of the thoracic aorta. The CT evaluation of intracardiac anatomy was inconsistent. It adequately defined septal defects and configurational (Ebstein anomaly) and bulboventricular loop abnormalities of the ventricles. However, valve anomalies were not adequately demonstrated by CT. The three-dimensional representation of cardiac and mediastinal vascular anatomy provided by this relatively noninvasive technique gives unique information in some cardiovascular anomalies. When faster scanning times are introduced, more definition of the cardiac structures should be possible, further increasing the diagnostic potential of CT.