الفهرس 
Embryology of the heart and extra-cardiac vesselsOnly 14 pages are availabe for public view
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Abstract
Congenital heart disease is one of the most difficult areas of diagnostic radiology. Accurate evaluation of the cardiac and related extra cardiac anatomy is critical for the clinical management of congenital cardiac anomalies. Echocardiography (ECHO) is the first-line modality of cardiac imaging show limitation in assessment of extracardiac vascular structures. Cardiac catheterization can providing hemodynamic information and enabling visualization of extracardiac great vessels. However, the role of diagnostic cardiac catheterization in pediatric cardiology is evolving due to its invasive nature and the exposure to radiation and iodinated contrast media and reserved for interventional procedures .MDCT angiography has emerged as an alternative to conventional coronary angiography with high spatial resolution, sensitivity and specificity.
In our study the role of Multi-detector CT angiography in the evaluation of cardiac and extra cardiac great vessels anomalies were assessed, it enrolled 40 patients (21 males and 19 females) with an age range between one month-12 years (mean age 25 months for male and 26 months for female). It included 26 patients with cardiac anomalies, 10 patients with extra cardiac great vessels anomalies and 4 patients post-operative for follow up.
All patients included in this study were initially examined by echocardiography and prospective ECG gated MDCT angiography except one case with arrhythmia examined by retrospective ECG gated MDCT angiography.
Our initial experience showed that ECG gated MDCT is capable of complementing echocardiography and replacing further diagnostic cardiac catheterization for anatomical delineation if performed with good contrast medium injection technique.
ECG gated MDCT angiography proved to be a worthy primary investigation tool in patients whom ECHO has been unable to clearly identify the extra-cardiac vascular anatomy. In our study, there is concordance between Echocardiography and MDCT angiography in cardiac anomalies while in extra cardiac great vessels anomalies, MDCT give more information which was missed by Echocardiography.
In spite of the risk of ionizing radiation and contrast medium injection the adoption of our minimally invasive, low dose protocol greatly reduces the time, radiation dose, contrast medium volume needed to perform an optimum CT angiographic technique make the MDCT good tool for pre and post-operative assessment of patients with congenital heart anomalies.