A dual contrast injection technique for multidetector computed tomography angiography of Fontan procedures.

Author(s): Greenberg SB, Bhutta ST

Affiliation(s): Department of Pediatric Radiology, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202 3591, USA. greenbergsbruce@uams.edu

Publication date & source: 2008-03, Int J Cardiovasc Imaging., 24(3):345-8. Epub 2007 Sep 6.

Extracardiac and lateral tunnel Fontan palliations result in caval venous return to the branch pulmonary arteries without prior blood mixing in the right atrium. Single contrast injection techniques result in suboptimal pulmonary computed tomography angiography since blood streaming results in asymmetric pulmonary flow of injected contrast. We used a dual injection technique--dorsal foot vein and upper extremity vein to achieve optimal simultaneous opacification of the inferior and superior venae cavae and branch pulmonary arteries. The resulting dataset allowed for excellent 3D volume renderings and multiplanar reformat images useful for stenosis, aneurysm, and metal stent evaluation.