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Abstract A fundamental understanding of the cardiac and extra-cardiac anatomy forms the cornerstone of diagnostic pediatric cardiology and is a pre-requisite for the proper interpretation and management of different cardiac and vascular abnormalities in pediatric patients with congenital heart disease. Primary evaluation of congenital cardiac abnormalities traditionally relies upon echocardiography and conventional angiography, both of which have potential limitations. Echocardiography is an operator dependant study, limited by a small window and patient movement. Conventional angiography is an invasive procedure with an inherent risk of catheter complication such as vessel damage, bleeding, stroke and infection. During angiography, overlapping of the pulmonary and systemic circulation often provides a confusing picture given complex anatomy. Another limiting factor of particular significance in young children is radiation dose and contrast administration during catheterization procedures. Three-dimensional MDCT provides an alternative to alleviate these pitfalls of traditional cardiac diagnostic studies. Development of multi-detector computed tomography (MDCT) and 3D software provides new methods for non-invasive visualization and evaluation of congenital cardiac abnormalities. In this study we examined the applications of CT angiography in the field of congenital heart disease focusing on its rule in the examination of extracardiac vascular abnormalities that commonly associates the congenital heart disorders. We found that this technique has the great potential of providing anatomical data not confidently obtainable by other currently used imaging modality, it could disclose changes not seen by other techniques, and can be used to verify findings seen with other modalities. These data has tremendous impact on the surgical decisions and planes. The technique is minimally invasive and although it carries the risk of ionizing radiation and contrast medium injection, still the wealth of information obtained overweigh the risk included. These risks are by far more tolerable when compared to catheter angiography Being minimally non invasive, the technique need to come after echocardiography and is likely to take place prior to catheter angiography as the combination of echocardiography and CT angiography data can provide cardiovascular anatomy in exquisite details which allow proper management of different cardiac and vascular abnormalities in pediatric patients with congenital heart disease. |