Three-dimensional reconstruction of abnormal ventriculoarterial relationship by electron beam CT

Purpose: Assessment of the relationships of the ventricles and great vessels is critical in evaluating cardiac anomalies before surgery. We investigated the usefulness of 3D CT in their demonstration. Method: From July 1995 through June 1996, 20 patients with abnormal ventriculoarterial relationships were analyzed by electron beam CT. A 3D gradient shading surface rendering was done on a workstation. We focused on the morphologies of the atria, ventricles, and great vessels and particularly their spatial relationships on the 3D images. Results: There were two cases of isolated ventricular inversion, three of anatomically corrected malposition, seven of congenitally corrected transposition, and eight of complete transposition. Anatomic presentations of 3D surface images in all were superior to cineangiography and echocardiography presentations and were consistent with intraoperative findings. Conclusion: 3D CT images provide useful information that is not available by sectional or projective imaging. Independent segmental analysis of the anomalies by this method provides a complement for surgeons to understand the spatial relationships of the vessels and chambers of the heart, which may be of value in preoperative planning.