Cardiopathies congénitales et radiographie thoracique chez l′enfant

Plain film examination is the most commonly performed cardiac imaging test in congenital heart diseases (CHD) and also the most underused and misinterpreted due to limited knowledge among current generations of radiologists and pediatricians. However, chest plain film is rapid, available and cost-effective and provides to the instructed practitioner essential clues for the diagnosis and follow-up of CHD. It nicely displays the anatomic relationships of the great vessels and is the best image of the pulmonary vascular pattern which is one arm of the diagnostic tripod of these diseases. Emphasis is put on the value of the lateral film to achieve a thorough follow up of cardiac morphology and size and of the hila. Because of marked advances in palliation and correction of these CHD, the great majority will survive in adult life increasing the number of patients prone to be examined by general radiologists. In children as in adults, the radiologist must be familiar with the patterns of the chest plain film in CHD to be able to help the patients during the follow-up. Moreover, this is a requisite for achieving pertinent protocol and interpretation of non invasive studies, namely cardiac MDCT and MR imaging, which are becoming the gold standard for precise delineation of cardiovascular anatomy and physiology in pre and post operative states.