Preoperative appearance of tetralogy of Fallot with pulmonary atresia in a
male infant. (A) Sagittal oblique maximum intensity projection
(MIP) CT image shows right ventricular hypertrophy (white arrow), VSD (black
double arrow), and overriding of the aorta. MPA is not visualized.
(B) Coronal oblique MIP CT image shows pulmonary atresia
(white arrow). (C) Axial oblique MIP CT image shows severe
hypoplasia of the branch pulmonary arteries. MPA is absent. Thin but
confluent branch pulmonary arteries produce the typical “seagull
wing” appearance. White arrows indicate RPA and LPA. (D)
Coronal oblique MIP CT image shows multiple MAPCAs arising from the
descending thoracic aorta (yellow arrows) and upper abdominal aorta (green
arrows). Ao = aorta, LPA = left pulmonary artery, LV = left ventricle, MAPCA
= major aortopulmonary collateral artery, MPA = main pulmonary artery, RPA =
right pulmonary artery, RV = right ventricle, VSD = ventricular septal
defect.