الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Precise and comprehensive evaluation of the intracardiac and extracardiac deformities in congenital heart diseases (CHD) is critical for surgical plan. Echocardiography is the first-line option for children with CHD because of its availability, safety, and capacity to provide hemodynamic parameters using Doppler flow studies. However, TTE is not robust for evaluating extracardiac structures because it is limited by its acoustic window and relatively lower spatial resolution (113).
The advanced multi-detector CT (MSCT) technology with improved spatial and temporal resolution has made it an effective tool in the assessment of CHD in infants and children (113).
The aim of this study was to evaluate the potential benefit of multidetector computed tomography for the diagnosis of pediatric congenital heart diseases. By comparing CT findings with previous echo findings in different types of congenital heart diseases of all patients.
This study was conducted on 100 patients (68 male and 32female ) with most of them at age group below one year (76 patients).
MDCT findings were interpreted by using systematic approach for diagnosis of congenital heart disease developed by Van Praagh (90&91). MDCT findings were compared with Echo findings and catheterization when available (40% of patients)
MDCT was equal to echo in in detection of orientation of cardiac apex, atrial situs viscerum, atrioventricular concordance and ventriculo-arterial concordance. MDCT was superior to echo in sinus venous and unroofed coronary ASD while echo was superior in other types of ASD, Echo was superior in VSD and PFO.
Summary
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MDCT was superior in detection pseudo-coarctation, MAPCAS, peripheral pulmonary stenosis, venous anomalies as well as coronary arteries anomalies. The agreement between MDCT and echo was very good in truncus arteriosus, good in aortic coarctation, moderate in aortic arch abnormalities and double SVC while being fair in PLSVC and APVR.
MDCT and echo were equal in diagnosis of pulmonary, mitral and aortic valves abnormalities while echo was superior in diagnosing tricuspid valve abnormalities. MDCT showed sensitivity (46.1%), specificity (97.7%), positive predictive value (75), and negative predictive value (92.3) in diagnosis of tricuspid valve abnormalities and moderate agreement with echo.
CONCLUSION
The current study showed that ECG gated MDCT is considered as an essential non-invasive diagnostic tool for the evaluation of congenital cardiac and extra cardiac great vessels. MDCT is complementary to echocardiography especially in complex heart abnormalities.
It also showed that MDCT is mandatory before any intervention as it provided more details than Echo in different types of CHDS.