Angiography for delineation of systemic-to-pulmonary shunts in congenital pulmonary atresia: evaluation with the dynamic spatial reconstructor.

In patients with pulmonary valve atresia, the arterial supply to the lungs is derived entirely from the aorta or its major branches. The anatomic detail of this arterial supply is usually identified by obtaining multiple selective arteriograms involving numerous injections of contrast material and x-ray exposures. In this study, we demonstrated that the information obtained from conventional diagnostic angiography in two patients with congenital pulmonary atresia was also clearly evident on scans from the dynamic spatial reconstructor (DSR), a high-speed three-dimensional computed tomographic system. Thus, numerous shunts, stenoses, and systemic collateral arteries were demonstrated by DSR scanning, which involved only one or two nonselective injections of a contrast agent and less x-ray exposure than that normally necessitated by angiographic study.