Computed tomography of septal defects

Septal defects are common congenital cardiac anomalies that may present in adulthood. Although echocardiography and magnetic resonance imaging are most frequently used to assess for and evaluate septal defects, multidetector computed tomography (CT), with its high spatial and temporal resolutions, multiplanar reconstruction capabilities, and wide field of view, is an excellent tool for detection and characterization of septal defects and for identification of associated anomalies of the heart and pulmonary vasculature. Knowledge of the CT appearances of septal defects and their respective associated abnormalities is critical for accurate reporting as well as for providing information for planning of surgical or percutaneous therapy. In this pictorial review, the CT appearances of various atrial and ventricular septal defects and associated shunts are described and illustrated.