Volumetric Computed Tomography Angiography in the Evaluation of Mediastinal Fluid Collections following Congenital Cardiac Surgery
Figure 1
Mediastinitis after Contegra conduit and late complication of large mediastinal fluid collection. ECG-triggered volumetric contrast-enhanced cardiac CT (AquilionONE, Toshiba medical systems, Otawara, Japan) is acquired at end systole (45% of cardiac RR cycle). Transverse views in 8-year male patient with moderate soft tissue/fluid collection around ascending aorta (Ao, in (a)). Relative stenosis of Contegra conduit (arrow, (a)). Patient also had osteolytic destruction of parts of sternum compatible with osteomyelitis (not shown). Diagnosis mediastinitis was based on CT findings and clinical findings. Ventricles at lower level (b). Nine months later; large mediastinal fluid collection and subtotal compression on the Contegra conduit (arrow, (c)). Note the secondary massive right ventricle (RV) dilatation due to outflow obstruction (d). Ao: aorta; LV: left ventricle; RPA: right pulmonary artery. Dose-length products of the CT scans were 26.4 mGy·cm for the first scan (a, b) and 29.5 mGy·cm for the second scan (c, d). Correction factor for chest CT at 100 kV for 8 years age was 0.026 mSv·mGy−1·cm−1; effective doses were 0.7 mSv and 0.8 mSv, respectively.
