This is an 11-years old girl with Tetralogy of Fallot (TOF) with pulmonary atresia, who came for a cardiac CT for the evaluation of major aorto-pulmonary collaterals (MAPCAs). The echo had picked up one MAPCA/PDA feeding the right pulmonary artery (RPA).
A gated study was performed. It showed 3 MAPCAs. The first is the MAPCA/PDA supplying the right lung (Figs. 1,2,3). The second is a smaller artery also supplying the right lung (Figs. 2,3). The third is a large MAPCA below the 2nd, supplying the left lung (Figs. 3,4). From a 3D perspective it was difficult to show all the vessels in a representative manner for the cardiologist and surgeon to understand.
Advanced segmentation techniques were used to demonstrate each MAPCA in a separate color (Figs. 5-7). The anatomy of the aorta (green), MAPCA 1 (blue), MAPCA 2 (brown) and MAPCA 3 (purple) can now be appreciated extremely well. Figs. 5 & 6 show a ghost of the heart and thorax for orientation, whereas Fig. 7 is without the ghost.