Direction, location, and size of shunt flow in congenital heart disease evaluated by ECG-gated multislice computed tomography

Objective To demonstrate the utility of multislice computed tomography (MSCT) in the evaluation of direction, location, and size of shunt flow in congenital heart disease. Background Transthoracic and transesophageal echocardiography, magnetic resonance imaging, and conventional angiography has been used to evaluate congenital heart disease; however, some are invasive and some do not provide accurate information about the spatial relationship to other organs. Methods Three patients with typical presentation of ventricular septal defect, atrial septal defect, and patent ductus arteriosus were recruited. Enhanced MSCT (Light Speed Ultra 16, General Electric) was performed with a 1.25-mm slice thickness, helical pitch 3.25. Following intravenous injection of 100 ml of iodinated contrast material (350 mg I/ml) at a rate of 3 ml/s, CT scanning was performed with retrospective ECG-gated reconstruction at 5 s and 30 s after injection. Results In all cases the information of direction, location, and size of shunt flow including left-to-right and right-to-left shunt with spatial relationship to other organs could be obtained non-invasively. Conclusion ECG-gated MSCT is a useful tool to evaluate congenital heart diseases with shunts.