Optimizing contrast administration in pediatric cardiovascular CT: Safety and technique

Cardiac computed tomography angiography (CCTA) has become indispensable in the management of congenital heart disease, facilitating diagnosis, treatment planning, and longitudinal surveillance. The application of intravenous (IV) contrast agents is critical for enhancing vascular structures and elucidating intricate cardiac morphology. Nonetheless, administering these agents in pediatric CCTA encounters distinct challenges, primarily attributable to children's unique physiological attributes, including reduced body mass, elevated heart rates, and increased susceptibility to both contrast agents and radiation exposure. This review examines the strategic use of IV contrast in pediatric CCTA, with a focus on the various types of contrast agents available, their clinical indications, associated safety profiles, and strategies for maximizing diagnostic yield while mitigating potential risks.