Illustration of a right modified Blalock-Taussig shunt.
(Radiology 2008;247:617–648) © RSNA, 2008. All rights reserved. Printed with permission.

As patient survival and quality of life have increased with advances in surgical management of congenital heart disease, so too has the role of radiologists. Developments in CT and MR imaging have led to more cross-sectional imaging of these patients and, with many patients being followed into the fourth and fifth decades of life, pediatric radiologists are not the only ones who must understand the surgical treatment and resultant postoperative anatomy.

In Part 1 of a 2-part review article in the June issue of Radiology (RSNA.org/radiology), Ana Maria Gaca, M.D., of Duke University in Durham, N.C., and colleagues review the median sternotomy procedure and its complications, as well as palliative procedures and complex repairs. Among the information presented:

• Palliative procedures—classic and modified Blalock-Taussig shunts, Waterston and Potts shunts, pulmonary artery banding, Glenn and bidirectional Glenn shunts

• Complex repairs—Fontan operation, Norwood and Damus-Kaye-Stansel procedures

"To be of assistance to the cardiologists and cardiothoracic surgeons caring for patients with congenital heart disease, radiologists must understand the basic anatomy and physiology of these patients before and after surgical repair," Dr. Gaca and colleagues write.

To access this Radiology article now, click here.

Multidetector CT and 3D CT Angiography for Suspected Vascular Trauma of the Extremities

39-year-old male construction worker who fell and accidentally fired a nail into his knee.

(a) Sagittal volume rendering adjusted to depict bone and metal CT shows the path of the nail and its lodging in the distal femur, with extension posteriorly. (b) Sagittal color-coded volume rendering to depict the artery demonstrate the nail to be near, but 2 cm away from the popliteal artery. The nail was successfully removed surgically.

Advances in CT technology continue to expand the applications of CT in the emergent setting, to the point that nearly every emergency department now has at least one CT scanner available at all times.

In an article in the May-June issue of RadioGraphics (RSNA.org/radiographics), Elliot K. Fishman, M.D., Karen M. Horton, M.D., and Pamela T. Johnson, M.D., discuss what radiologists should know—with regard to CT angiography, optimization of current multidetector CT acquisition protocols, utility of 2D and 3D displays and CT findings in the presence of vascular injury—to ensure prompt diagnosis and treatment of patients with traumatic injuries to the extremities.

Specifically, the authors, of The Johns Hopkins University, address:

• 64-section CT protocol design

• Data analysis

• Potential pitfalls

• Imaging findings

• Evidence from the literature

"Whether the injury be a stab wound, a gunshot wound or an injury from a motor vehicle accident, a CT study that allows visualization of injury to bone, muscle and vasculature seems to be an ideal way of limiting radiation dose by decreasing the number of studies performed," the authors conclude.

To access this RadioGraphics article now, click here.