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J Thorac Cardiovasc Surg 2003;125:36-39
© 2003 The American Association for Thoracic Surgery

Evolving Technology (ET)

Application of helical computed tomographic angiography with differential color imaging three-dimensional reconstruction in the diagnosis of complicated congenital heart diseases

Isao Shiraishi, MD, PhD, Yasutoshi Yamamoto, MD, Seiichiro Ozawa, MD, Ayumi Kawakita, MD, Kentaro Toiyama, MD, Toshikatsu Tanaka, MD, Koichi Sakata, MD, PhD, Takashi Hayano, MD, PhD, Toshiyuki Itoi, MD, PhD, Masaaki Yamagishi, MD, PhD, Kenji Hamaoka, MD, PhD Kyoto, Japan

From the Division of Pediatrics, Division of Pediatric Cardiovascular Surgery, Children Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Received for publication April 24, 2002. Accepted for publication May 30, 2002. Address for reprints: Isao Shiraishi, MD, Division of Pediatrics, Children Research Hospital, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamikyo-ku, Kyoto, Japan 602-8566 (E-mail: isao@koto.kpu-m.ac.jp).

The first 300 words of the full text of this article appear below.


   Introduction
 
Three-dimensional (3D) imaging technology, such as magnetic resonance imaging (MRI),Go Go 1,2 helical computed tomography (CT),Go Go 3,4 and electron-beam CT,Go 5 has markedly progressed and allows 3D visualization of congenital heart anomalies from any angle of view and perspective.Go 6 However, it is sometimes difficult to understand the accurate morphologic conditions, even with the 3D images, because the anomalous components are generally intricate and tortuous. To obtain more understandable 3D images, we have proposed the differential color-imaging technique of helical CT angiographyGo 7 by modifying the color-coded 3D reconstruction.Go 8 After arteries and veins were carefully demarcated according to the shape, continuity, and CT density of sequential tomographic images, the 3D image of each component was displayed in red and blue. Here we report a summary of the helical CT angiography examination with 3D color coding and assess the safety, utility, reliability, and limitation of the helical CT examination.


   Methods
 
Patients
Between April 1998 and March 2001, differential color-imaging 3D reconstruction was applied for 77 examinations in 66 patients (24 neonates, 22 infants, and 20 children; 38 male and 28 female patients). The study population included patients with pulmonary atresia (PA) with ventricular septal defect (VSD; n = 10), coarctation of the aorta (n = 8), hypoplastic left-heart syndrome (HLHS; n = 7), total anomalous pulmonary venous drainage (TAPVD; n = 7), tetralogy of Fallot (n = 7), peripheral pulmonary stenosis (n = 5), partial anomalous pulmonary venous drainage (n = 4), interruption of the aortic arch (IAA; n = 4), asplenia with pulmonary atresia (n = 3), and so on. The median age of the 66 patients was 3.0 months (range, 5 days-16 years).

Helical CT
Helical CT angiography (X Vigor Laudator, single scan detector, Toshiba) with a differential color-imaging technique was performed with an oral sedation of chloride hydrate for infants and young children or with a breath hold . . . [Full Text of this Article]




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