 Good morning, everyone. This is Dr. Anshil Vashne, JR-3 raid agnostics from IMS BHO Varanasi. Today I'm going to present CT angiography, a paper on CT angiography study in congenital and developmental anomalies of heart and brain vessels. The objective of the study is to assess the role of CT in the evolution of various congenital and developmental heart anomalies of heart and also in detection of heartache in a cable pulmonary vascular and coronary artery developmental anomalies. The congenital heart disease remains a major cardiac problem in the pediatric population and the emergence of 64-slice imital detected CT has been a major technical breakthrough in the cardiac imaging. The enhanced preoperative understanding of the congenital heart is provided by the CT angiography simplifies surgical decision making and improves the outcome. It supersedes the conventional angiography and 2D echocardiography in terms of more reliability and noninvisiveness and also the evaluation of extracardic structures. Also, although the MRI does not entail ionizing radiation and can be used for function and anemic multiphase contrast enhanced imaging, it has its own limitations due to its limited availability, high cost, poor temporal resolution, long examination times frequently requiring stating young children. It's a cross-sectional observational study with consecutive sampling of 100 patients who were suspected to have congenital heart disease on the basis of clinical findings or echocardiography findings, though patients who had undergone surgeries for the correction of the heart disease or had allergies to the contrast agents, CT contrast agents, were excluded from the study. The study was carried out on GE Lightspeed VCT128-slide multi-director CT machine with a retrocollimation of 64.6 mm, tube voltage 120 kV, tube current of 400 mm, adult 220 mm and pediatric patients, a sand-slice technique and endless-slice interval of 0.625 mm. After requiring the images, post-processing was done on AW4.7 workstation and multi-painter reformation, MIP and 1 million ring were performed. The images were studied in a sequential approach by establishing the cardiac sidedness, the arterial chambers, ventricular chambers, gate arteries, avatars, pulmonary arteries, establishing the cardiac connections, associated malformation like intracardial communication and wall-billow pathologies were studied. The cardiac position was later mined. Autic arch and branching patterns, pulmonary artery, veins, SVC, IVC, their core training pattern, systemic veins, migra, hemizagal, bicocephalic veins, their patterns, pulmonary artery, and their anomalies, polarization of flavors, pantheism of the heart, position of the heart, secondary changes in the cardiac chamber and lung parenchyma, and many bone abnormalities were looked for. A list of different anomalies were identified as shown in the below. Ranging from arterial septal, ventricular septal, vitroindectal arteriosus, top two rare anomalies like DORV, miscellaneous sinus defects, tyrosine anomalies. As we can see in this image, this is an axial image, axial CT image. There's a defect between the right atrium and left atrium on the left image. This is septum prime, septum prime of ASD. And on contrary, here we can see more proximally towards the sinus menosis. There's a defect between the two atria. This is the sinus menosis type of ASD. Similarly, here we can see the defect between the two ventricles, right and left ventricles. The first one depicts the muscular ASD. The second one depicts the more towards the outflow tract. And it's a very membranous ASD. Patein ductus arteriosus, Patein ductus arteriosus is the persistent communication between the pulmonary trunk and aortic arches. And it indicates the presence of congenital heart disease. Some other congenital heart disease. Toff is characterized by the detector of infundibular stenosis, right ventricular outflow tract hypertrophy, VSD, overriding of aorta. And it's the most common congenital cyanotic heart disease. Total anomalous pulmonary wingers connection shows drainage of all the pulmonary veins into the, all the pulmonary veins into right atrium instead of the left atrium. Coactation of aorta, as we can see, is a characterized thinking of the arch of aorta which does disturb the left, origin of left subclavian artery. It can be of two types, pre-ductal and post-ductal. Post-ductal is the most common type and is seen in adults while the pre-ductal is seen in infants. DORV is characterized by the origin of both the pulmonary trunk and aortic arch, ascending aorta from the right ventricle, morphological right ventricle. And it's almost always associated with VSD. Transmission of great artery is the second most congenital cyanotic heart disease. And the most common congenital cyanotic heart disease to present in the first 24 hours of life with cyanosis. It is characterized by origin of aorta from right ventricle and origin of main pulmonary artery from the left ventricle. Aortic arch anomalies are the most common rate vessel anomalies. Here is a case of right-sided aortic arch. As you can see, the arch is rising towards the right of the trachea with aberrant left subclavian artery, which is comparison the esophagus causing dysphagia. Bovine arch is the most common congenital variant of aortic arch and it is characterized by the common origin of right brachycephalic and left brachycephalic trunk and left common carotid artery. Now, coming to the epidemiological distribution in our cases, 40% of the cases were aging from 1 to 15 years of age. And the most common symptom was breathlessness followed by view of discoloration, that is, cyanosis. Among the cardictions, VSD was the most common shunt present in the 45th case of the 100th of the cases. And TOG was the most common congenital cyanotic heart disease, 29% of the cases. Among the great vessel anomalies, aortic arch anomalies was the most common anomalies, representing 16% of the cases powered by SVC anomalies, 13% of the cases powered by pulmonary artery and withdrawal at RTs anomaly and other anomalies. And in conclusion, CT has established itself as a vital modality in the evolution of congenital heart disease both in children and adults. And it is an important complement to the ecocardiography particularly by MRIs, whether it is vaccinated or is not expected to provide the desired information due to expected artifacts. It is also a first-line imaging modulating some reason involving coronary arteries, links and MAPCAS. The scanning protocol should be optimized for the clinical question as the underlying congenital heart disease previous surgery intervention and pre-patient hemodynamics. Addition should be minimized to keep it as low as reasonably possible. These are the references. Thank you.