Cardiovascular CT is a valuable tool for evaluating congenital heart disease in children. It provides high spatial and temporal resolution to depict complex anatomy. Key applications include assessing pulmonary blood flow in pulmonary atresia, vascular rings prior to surgery, coronary artery anomalies, and postoperative complications. Careful patient preparation and protocols are needed given pediatric concerns. CT enables simultaneous evaluation of vascular structures, airways, and cardiac function to comprehensively evaluate complex congenital heart disease.
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
In this presentation we will discuss different techniques of MDCT Cardiac imaging to role out different causes of chest pain to help cardiologist in management of the patient.
We shall discuss it case by case.
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
In this presentation we will discuss different techniques of MDCT Cardiac imaging to role out different causes of chest pain to help cardiologist in management of the patient.
We shall discuss it case by case.
Acute stroke management
IV thrombolysis guidelines
IV thrombolysis side effects
Early CT changes in stroke
ASPECTS scoring
AHA stroke guidelines
Thrombolysis controversies
Gray scale ultrasound has been used in evaluation of the eye since late 20 century.
More recently, color doppler imaging of retrobulbar vessel has been introduced as a useful adjunct to clinical examination and cross-sectional imaging for evaluating various pathologic condition in the orbit.
Although gray-scale ultrasound display the anatomy of the orbit well, color doppler imaging provides additional information about the vasculature of the orbit and information regarding direction and velocity of blood flow.
The color doppler changes in diabetes retinopathy has been a topic of discussion for decades and numerous studies have been conducted to study these changes.
Not enough standard textbook literature is available stating these changes, but meta- analysis of studies stated a common finding of increased vascular resistance in intra orbital vessels.
However, no consensus on the cut off limits of various doppler parameters for diabetic retinopathy have been reached.
This presentation includes stroke and infarct latest defination an pathophysiology and CT MRI imaging features and management . This presntation help alot. Thanks
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. OVERVIEW
• Introduction
• CT Technique and protocols
• Patient preparation
• Iv contrast agents and injection protocol
• Artifacts in cardiac CT
• How to read cariac CT
• Clinical appications of pediatric cardiac CT
3. introduction
• Designed by Godfrey N.
Hounsfield to overcome
the visual representation
challenges in radiography
and conventional
tomography by
collimating the X-ray
beam and transmitting it
only through small cross-
sections of the body
4. G.N.HOUNSFIELD ALLAN M. CORMACK
In 1979, G.N. Hounsfield shared the Nobel Prize in Physiology &
Medicine with Allan MacLeod Cormack, Physics Professor who
developed solutions to mathematical problems involved in CT.
5. • Echocardiography (echo) comes closest to
meeting the criteria for an ideal diagnostic test,
but there are a number of instances where it is
unable to provide all the requisite information
for therapeutic decision making due to the lack
of acoustic windows, complexity of the
anatomy, limited spatial resolution, or the lack
of tissue characterization
6. • BASIC PRINCIPLE :
• The internal structure of an object can be
reconstructed from multiple projections of
the object.
• CT scanning is a systematic collection
and representation of projection data.
7. Prerequisites for cardiac CT
• Demands
– -complex anatomy
– Small dimensions
– Rapid movement
1. HIGH SPATIAL RESOLUTION
-depiction of vessel wall and small
coronary branches
2.HIGH TEMPORAL RESOLUTION
- Reduce motion artifacts
3. FAST COVERAGE
- Short breath hold time
4.SYNCHRONISATION WITH CARDIAC
CYCLE
- -ecg gating for end diastole and end
systole
5.CONTRAST RESOLUTION
8. CT Technique
• There are four parts to an optimal CT for pediatric
cardiovascular indications:
• planning
• acquisition
• processing,
• and interpretation
9. Planning
• It is the most important step,
ensuring that the
appropriate technology and
technique are chosen for the
given indication, and
adjusted to the patient's
unique anatomical and
hemodynamic situation.
Acquisition
• It involves the actual
performance of the study,
and involves choice of the
scanning and contrast
injection protocol, and real
time adjustment of the
technical parameters
10. Processing
• It involves sophisticated
algorithms that allow the
manipulation of the 3D
image dataset for advanced
visualization such as volume
rendering (VR) or virtual
angioscopy
• The final part is
interpretation of the
images, and creation of the
imaging report
11. Spatial resolution
• Primary strength of CT
• Narrowest distance
between which 2 objects
may be discribed
• In plane :(x ,y)
-0.5 mm
• through plane : plane
- 0.5 to 0.625 mm`
TEMPORAL RESOLUTION
• Vital for coronary imaging
• Ability to resolve fast moving
objects( shutter speed) or time
required to acquire one image
• Temporal resolution must be
less than length of diastolic
phase
• Primary achieved via:
– Fast gantry rotation time
– Multi-segment reconstruction
– Dual source CT
12. ECG Synchronization
• Non-ECG–gated scanning can provide diagnostic images of the
extracardiac vasculature in most patients with CHD.
• For evaluation of the aorta, pulmonary artery and pulmonary veins,
ECG synchronization is usually not necessary.
• ECG gating is the preferred technique for evaluation of
– the morphology of the heart chambers,
– including assessment of ventricle aneurysms, cardiac thrombi, cardiac tumors,
evaluation of small aortopulmonary collaterals in pulmonary atresia, and for
coronary artery assessment
13.
14. Patient Preparation
• Breath Holding
• Premedication: With the advent of 64-slice scanners, with temporal
resolutions of about 50 msec, patients with heart rates of up to 120
bpm can be scanned without premedication
• Sedation: sedation is required for evaluation of infants and children
who are 5 years of age or younger to prevent gross motion artifacts
during scanning
15. Intravenous Contrast Agents and
Injection Protocol
• Contrast Agents:
– ionic media -sodium and/or meglumine
diatrizoate and iothalamate
– nonionic contrast media - iohexol, iopamidol,
ioversol, and iodixanol
Contrast Reaction
Idiosyncratic
Nonidiosyncratic
Premedication- prednisone 50 mg, diphenhydramine
16. Intravenous Contrast Injection
• The usual dose of intravenous iodinated contrast media
is 2 mL/kg with an iodine concentration of 240 to 370
mg/mL
• The greater the iodine concentration, the better the
vascular enhancement, but this also increases the
contrast viscosity
• in general, the more rapid the rate of contrast
injection, the greater will be the level of vascular
enhancement.
• The degree of enhancement is inversely related to
body weight, which is an advantage when imaging
small infants.
17. Artifacts in Cardiac CT
• Awareness of the various artifacts in cardiac CT is essential
to avoid errors from false-positive and falsenegative
interpretation.
• Image Noise
• Pulsation Artifacts
• Respiratory Artifacts
• High Contrast Artifacts
• Inhomogeneous Contrast
• Partial Volume Effects
18. Contrast-Induced Nephropathy
• CIN is defined as an increase in serum creatinine levels by >25%
or 0.5 mg/dL occurring within 3 days after intravascular contrast
administration in the absence of an alternative etiology
• seen within 1 to 2 days, peaks in approximately 4 to 7 days, and
returns to normal by 10 to 14 days
• Risk factors for CIN include
– pre-existing renal insufficiency,
– diabetes mellitus associated with renal impairment,
– large volume of injected contrast media or repeated doses within 72 hours,
– concurrent use of nephrotoxic drugs like aminoglycosides and nonsteroidal
anti-inflammatory agents,
– dehydration, and severe congestive heart failure
19. BIOLOGICAL EFFECTS OF IONIZING RADIATION
• TYPES:
1.DETERMINISTIC EFFECT
2. STOCHASTIC EFFECT
• deterministic (i.e., dose dependent):
– which can present weeks after exposure,
– may result in skin injury, hair loss, and lens injury
20. • Stochastic: which is genetically determined
and not dose dependent.
• Stochastic injury can result in cancer,
pregnancy complications, and inheritable
diseases
31. Ten Common Indications for Pediatric
Cardiac CT
Neonate 1 .
Pulmonary
atresia
Source of pulmonary blood flow:
Major aortopulmonary collaterals
(MAPCA) versus ductal dependent
pulmonary flow
2.
Heterotaxy
-Diffuse hypoplasia of the aortic arch,
-anomalous pulmonary venous
Return,
-branch pulmonary artery stenosis
prior to modified Blalock–Taussig
shunt placement
Moss and Adams 9th Edition
32. Indications
3.Tetralogy of Fallot Branch pulmonary artery
stenosis
4. Anomalous
pulmonary venous
return
Mixed TAPVR,
obstructed TAPVR,
repaired TAPVR,
Scimitar syndrome
Infants 5.Coarctation Diffuse hypoplasia of the arch,
atypical coarctation
6.Vascular ring/sling Type of ring/sling,
intrinsic versus extrinsic stenosis
of airway
Moss and Adams 9th Edition
33. Indications
7.Coarctation- post
repair
Status of aortic arch,
collaterals
8.Vascular mediated
airway
compromise
Fixed versus dynamic airway
stenosis, effect on lung.
Older child 9.Anomalous origin
of coronary artery
Type of AAOCA,
presence and length of
intramurality,
Ostial stenosis,
relationship to commissure
10.Aortopathy related
to connective
tissue disease
Screen for aortic dissection
Moss and Adams 9th Edition
34. Systemic Veins
• MRI is preferred
• CT may be used when MRI is contraindicated.
• Acquired thrombosis or stenosis of systemic
veins after
– venous cannulation,
– surgery, or
– prior cardiaccatheterization
35. Systemic Veins
• A delayed phase of contrast enhancement is needed to
demonstrate the left SVC or an interrupted IVC with azygos
connection- for planning cavopulmonary shunt placement
• Screening for thrombosis of the Fontan pathway
39. Pulmonary Veins
• In pts TAPVR, CT is indicated when surgically relevant data
cannot be obtained by echo.
• CT helps in presurgical planning by delineating stenosis or
obstruction, site of abnormal connections, and the course of the
anomalous vein in relation to the left atrium.
• Recurrent PV obstruction is the most frequent reason for repeat
surgery following repair of TAPVR.
• CTA can demonstrate the type of stenosis and the entire course of
the individual veins to better effect than echo
• In pulmonary venolobar syndrome (scimitar syndrome), CT can
simultaneously evaluate pulmonary artery anatomy, anomalous
systemic arterial supply to the lung, anomalous pulmonary
venous drainage as well as lung anatomy
44. • Congenital pulmonary vein stenosis and atresia are rare.
• CT angiography is the diagnostic modality of choice to
confirm the diagnosis of diffuse or multifocal pulmonary vein
stenosis
45. PULMONARY ARTERIES
• In pulmonary atresia, nongated CT is helpful in identifying the
– source of pulmonary blood flow by determining the
confluence, size, and location of the mediastinal pulmonary
arteries
– the presence and size of a PDA,
– the presence and location of major aortopulmonary
collaterals(MAPCAs) and
– presence of pulmonary artery stenosis prior to surgery
46. PULMONARY ARTERIES
• tetralogy of Fallot with pulmonary atresia or severe RVOT obstruction
- Juxtaductal stenosis may be seen near the origin of the left pulmonary
artery .
• Patients with syndromes like Williams–Beuren, Alagille, Ehlers–Danlos,
and Takayasu arteritis: Peripheral pulmonary artery stenosis is often
multifocal.
• CT is also effective for clarifying pulmonary artery morphology in the
setting of truncus arteriosus and ductal origin of the pulmonary artery
47. Role of CT in aortic abnormalities
• CT plays an important role in the delineation of aortic abnormalities
in children
– preoperative and postoperative evaluation of coarctation ,
– interrupted aortic arch ,
– aortopulmonary window,
– supravalvular or subvalvular aortic stenosis , and aortopathy
related to connective tissue disease
• In neonates, it may be difficult by echocardiography,
especially in the setting of a large PDA, to diagnose the
presence of coarctation, or differentiate diffuse hypoplasia
from interrupted aortic arch
49. FOR ASSESMENT OF CORONARY ARTERIES
• Potential coronary anomalies of significance in children and
young adults include
– anomalous origin from the contralateral aortic sinus with
intramural or intramyocardial course ,
– single coronary artery,
– Anomalous pulmonary artery origin ,
– high takeoff, and multiple ostia of the coronary arteries
coronary CT in children Kawasaki disease to
determine the presence of coronary involvement,
• distal coronary aneurysms,
• mural thrombus, and
• coronary stenosis,
52. FOR ASSESMENT OF CORONARY ARTERIES
• There is an increased incidence of coronary artery
anomalies in CHD.
• With new generation CT, breath holding may not be
necessary to determine coronary artery origins even
in neonates
• Presurgical identification of coronary artery
anomalies is particularly important in patients with
– transposition of the great vessels,
– tetralogy of Fallot,
– truncus arteriosus, and
– Pulmonary atresia with intact ventricular septum
53. Vascular Mediated Airway
Compromise
• This is one of the most important indications for CT due to its
ability to simultaneously assess the vascular anatomy, as well
as the presence and severity of airway compromise
• Common entities include
– vascular rings and sling,
– innominate artery compression syndrome, and
– bronchial compression related to dilated pulmonary
arteries or ascending aorta
54. Pulmonary sling: Posterior view from a
volume-rendered CTA in a 13-month-old male-
anomalous origin of the LPA from the RPA with
a retrotracheal course of the LPA
55. Intracardiac Pathology and Ventricular Function
• intra-atrial thrombus and thrombus associated with ventricular
aneurysm.
• It can demonstrate dystrophic calcification associated with myxoma.
• An important application of CT in the setting of cardiac tumors is to
assess the coronary artery anatomy prior to planning of surgical
resection.
• CT should not be a primary choice for evaluation of ventricular
function in children.
• To assess ventricular function in those with pacemakers or
othercontraindications to MRI
56. Postoperative and Postprocedural Indications for CT
• For assessing complications of Transcatheter placement of
endovascular metallic stents in pulmonary and systemic arteries and
veins in children with CHD
• Conventional digital angiography is the gold standard for identifying
in-stent restenosis, but it is not practical for long-term follow-up
• to determine stenosis or obstruction of modified Blalock–Thomas–
Taussig shunt.
• To determination of patency of Glenn and Fontan circuits and
screening for venovenous collaterals
• CT can play a role in evaluating pulmonary artery stenosis following
arterial switch procedure using a “LeCompte maneuver”
57. Emergent Indications
• CT angiography is the modality of choice in emergent situations
like suspected aortic dissection in patients with Marfan syndrome,
Loeys–Dietz syndrome and other connective tissue disorders.
• Evaluation of pulmonary embolism in the setting of CHD
• for urgent evaluation of source of emboli to the brain in the
setting of an acute cerebrovascular accident
58. Conclusion
• CT is now a major diagnostic tool in children with
heart disease
• multidetector CT has evolved over the last few years,
• Ct provides a number of important advantages for
pediatric cardiovascular disease, including
– isotropic high-resolution imaging without the need for
sedation or breath holding,
– volumetric coverage of the whole chest,
– high temporal resolution,
– novel radiation reduction tools with 60% to 80% reduction
in radiation exposure when compared to 64-detector .