Eur Radiol (2007) 17: 151–162 DOI 10.1007/s00330-006-0300-8 PEDIATRIC Sebastian Ley Julia Zaporozhan Raoul Arnold Joachim Eichhorn Jens-Peter Schenk Herbert Ulmer Karl-Friedrich Kreitner Hans-Ulrich Kauczor Received: 28 February 2006 Revised: 9 April 2006 Accepted: 18 April 2006 Published online: 24 June 2006 # Springer-Verlag 2006 Preoperative assessment and follow-up of congenital abnormalities of the pulmonary arteries using CT and MRI Abstract Congenital heart disease (CHD), including complex anomalies of the pulmonary arteries, are now earlier diagnosed and treated. Due to improvements in interventional and surgical therapy, the number of pa- tients with the need for follow-up examinations is increasing. Pre- and postinterventional imaging should be done as gently as possible, avoiding invasive techniques if possible. With the technical improvement of multi- detector-row computed tomography (MDCT) and magnetic resonance im- aging (MRI), both techniques are increasingly used for noninvasive assessment of the pulmonary vascu- lature in children with CHD. Knowl- edge of the most common diseases affecting the pulmonary vasculature and the kind of surgical and interven- tional procedures is essential for optimal imaging planning. This is especially important because inter- ventions can be positively influenced by high-quality imaging. Therefore, the most common diseases and pro- cedures are described and imaging modality of choice and important image findings are discussed. Keywords Pulmonary arteries . MDCT . MRI . Paediatric Introduction Congenital heart disease (CHD) is the collective term for congenital malformations affecting the heart, pulmonary arteries and aorta. Most cases of CHD are thought to be multifactorial and the result of a combination of genetic predisposition and environmental stimulus. Due to the complex nature of CHD, single numbers for uniform types of malformations affecting the pulmonary arteries are not known. In general, CHD occurs in 0.5 – 0.8% live births, indicating that about 1.5 million children world wide are born with a cardiac malformation each year [1]. The spectrum of anatomic malformations ranges from relatively simple to very complex. About 2–3 out of 1,000 newborn infants will become symptomatic with heart disease in the first year of life. Nowadays, the diagnosis is most often established within the first month [2]. Many children with CHD require surgical or catheter intervention, either corrective or palliative. With technical improvement, survival rate has increased dramatically, leading to a growing number of patients requiring serial postoperative follow-up. Residua, sequelae and complications determine the long-term outcome after operation for CHD [3]. Duly, detection and quantification of morphologic and functional abnormalities are required for accurate and preferably noninvasive imaging methods. S. Ley . J.-P. Schenk Department of Pediatric Radiology, University Children’s Hospital, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany S. Ley (*) . J. Zaporozhan . H.-U. Kauczor Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany e-mail: ley@gmx.net Tel.: +49-6221-422494 Fax: +49-622142 R. Arnold . J. Eichhorn . H. Ulmer Department of Cardiology, University Children’s Hospital, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany K.-F. Kreitner Department of Radiology, University Hospital Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany R. Arnold Department of Pediatric Cardiology, University Children’s Hospital, Mathildenstrasse 1, 79106 Freiburg, Germany