Extracardiac and lateral tunnel Fontan palliations result in caval venous return to the branch pulmonary arteries without prior blood mixing in the right atrium. Single contrast injection techniques result in suboptimal pulmonary computed tomography angiography since blood streaming results in asymmetric pulmonary flow of injected contrast. We used a dual injection technique--dorsal foot vein and upper extremity vein to achieve optimal simultaneous opacification of the inferior and superior venae cavae and branch pulmonary arteries. The resulting dataset allowed for excellent 3D volume renderings and multiplanar reformat images useful for stenosis, aneurysm, and metal stent evaluation.
A wide variety of injuries were identified in children with ATV accidents. Partial foot amputation, an unusual injury, was identified in three children. Brain injuries and lung contusions detected by computed tomography were associated with long-term disability and death. Radiologists need to be aware of injuries associated with ATV accidents.
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