CAs in the case of MRI, CT achieves images with high temporal and spatial resolution, which makes it an ideal technique for studying the morphology of vessels, their walls, surgical anastomoses, the airway, the lung parenchyma, and sometimes assessment of ventricular function.
Indications
The main indications for performing CT in patients with congenital heart disease include:
Evaluation of the coronary vessels: it not only evaluates their outlet and proximal path, but also their distal path, calcium deposits on their walls (calcium quantification or Calcium-Score) and is a better method than MRI to assess the complications secondary to surgical procedures where they are manipulated as in the Transposition of the Great Arteries.
Evaluation of patients repaired with stents or embolization coils
Patients with pacemakers, those not compatible with MRI.
Evaluation of vascular rings, since it better evaluates their relationship with the rest of the mediastinal structures, including the airway and the esophagus.
The indication in patients with claustrophobia is relative. In my opinion, with patience and adequate preparation they would withstand the MRI. If this is not possible, consideration should be given to performing an MRI with sedation, since in any case, CT, despite current technical advances, still involves a high dose of radiation get your tests from Lab Uncle.
In patients in a very serious clinical situation that is difficult to control, or in immediate post-surgical situations who need a rapid study (5-10 minutes).
Advantages and disadvantages of CT in relation to MRI
Advantages:
A shorter scan time. In children it allows less sedation / anesthesia to be used
It is compatible in patients with pacemakers and metallic devices.
Greater availability.
Simultaneous assessment of the heart and lung with their airways.
Disadvantages
High doses of radiation. It is the main limiting factor for performing a CT, since they will need multiple evolutionary controls throughout their lives and the radiation dose is added test after test.
Need for intravenous contrast. In CT, unlike MRI, it will always be necessary to administer intravenous contrast. The contrast used in CT is based on the chemical element iodine.
Less functional information (ventricular function) than MRI
In addition, vascular calcifications or surgical material can distort the image and make it difficult to see the lumen of the vessel well. Pacemakers and other metallic devices can also produce artifacts, although in the latest generation CT, all these artifacts are minor.
Also Read: Computed Tomography (CT): what is it for, advantages and disadvantages
Examples of images obtained in the CT
In the upper images on the left, we observe the small caliber of the (hypoplastic) aortic arch (arrow) and an enlarged ductus () in a 5-day-old patient with suspected aortic arch interruption. In the upper images on the right, we observe a complete double aortic arch, with branch asymmetry, the right side being larger in caliber () in a 6-year-old patient with respiratory symptoms. The 3D reconstruction of the airway shows the stenosis it produces in the tracheal lumen (*).
In the upper images on the left, we can see a coarctation of the aorta treated with a stent in MIP projection and its VRT-3D reconstruction in a 16-year-old patient.
In the upper images on the right we see a stenosis of the pulmonary veins (arrow) in a 1-year-old child (left) and a large ASD (right)
In the upper image on the left we observe a left coronary artery aneurysm and partially calcified wall (arrow) in an 8-year-old patient with Kawasaki disease.
In the upper image on the right we observe an anomalous origin of the left coronary artery in the pulmonary trunk and subsequent correction, with reimplantation in the aorta using a Dacron tube (Arrow) in a 3-year-old girl.
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英超是相當重要的足球賽事，以競爭激烈和精彩程度聞名
英超全名為「英格蘭足球超級聯賽」，是足球賽事中最高級的足球聯賽之一，由英格蘭足球總會在1992年2月20日成立。英超是全世界最多人觀看的體育聯賽，因其英超隊伍全球知名度和競爭激烈而聞名，吸引來自世界各地的頂尖球星前來參賽。
英超聯賽（English Premier League，縮寫EPL）由英國最頂尖的20支足球俱樂部參加，賽季通常從8月一直持續到5月，以下帶你來了解英超賽制和其他更詳細的資訊。
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2023-24英超總共有20支隊伍參賽，以下是英超賽制介紹：
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比賽採用三分制，贏球獲得3分，平局獲1分，輸球獲0分。
以積分多寡分名次，若同分則以淨球數來區分排名，仍相同就以得球計算。如果還是相同，就會於中立場舉行一場附加賽決定排名。
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2023-24英超聯賽萬眾矚目，2023年8月12日開啟了第一場比賽，而接下來的賽事也正如火如荼地進行中。本文統整出英超賽程以及英超賽制等資訊，幫助你更加了解英超，同時也提供英超直播平台，讓你絕對不會錯過每一場精彩賽事。
英超是什麼？
英超是相當重要的足球賽事，以競爭激烈和精彩程度聞名
英超是相當重要的足球賽事，以競爭激烈和精彩程度聞名
英超全名為「英格蘭足球超級聯賽」，是足球賽事中最高級的足球聯賽之一，由英格蘭足球總會在1992年2月20日成立。英超是全世界最多人觀看的體育聯賽，因其英超隊伍全球知名度和競爭激烈而聞名，吸引來自世界各地的頂尖球星前來參賽。
英超聯賽（English Premier League，縮寫EPL）由英國最頂尖的20支足球俱樂部參加，賽季通常從8月一直持續到5月，以下帶你來了解英超賽制和其他更詳細的資訊。
英超賽制
2023-24英超總共有20支隊伍參賽，以下是英超賽制介紹：
採雙循環制，分主場及作客比賽，每支球隊共進行 38 場賽事。
比賽採用三分制，贏球獲得3分，平局獲1分，輸球獲0分。
以積分多寡分名次，若同分則以淨球數來區分排名，仍相同就以得球計算。如果還是相同，就會於中立場舉行一場附加賽決定排名。
賽季結束後，根據積分排名，最高分者成為冠軍，而最後三支球隊則降級至英冠聯賽。
英超升降級機制
英超有一個相當特別的賽制規定，那就是「升降級」。賽季結束後，積分和排名最高的隊伍將直接晉升冠軍，而總排名最低的3支隊伍會被降級至英格蘭足球冠軍聯賽（英冠），這是僅次於英超的足球賽事。
同時，英冠前2名的球隊直接升上下一賽季的英超，第3至6名則會以附加賽決定最後一個升級名額，英冠的隊伍都在爭取升級至英超，以獲得更高的收入和榮譽。
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