CT of congenital heart disease: normal anatomy and typical pathologic conditions

Computed tomography (CT) plays an important supplementary role in the evaluation of patients with congenital heart disease (CHD). Fast multisection spiral CT can be used to obtain isotropic volume data, and high-quality two- and three-dimensional multiplanar reformatted images can be created to accurately and systematically delineate the normal and pathologic morphologic features of the cardiovascular system. CT may be technically challenging and demanding in uncooperative young children. However, it can be used to systematically evaluate the aorta, pulmonary artery, pulmonary vein, cardiac chambers and ventriculoarterial connection, relationship between the upper lobe bronchi and pulmonary arteries, coronary artery, valves, systemic veins (superior vena cava, inferior vena cava, hepatic veins), and visceral situs with a step-by-step approach. This approach may be helpful in understanding the anatomy of the cardiovascular system in CHD patients. CT has both advantages and disadvantages in evaluating patients with CHD. Nevertheless, it is useful in this setting, and radiologists who perform CT in young children with CHD should be familiar with the advantages and disadvantages of CT and with the normal anatomy and typical pathologic conditions in affected patients.