The small dimensions and rapid movement of coronary arteries have made their evaluation with computed tomography (CT) challenging. However, because of the dramatic development of multislice CT (MSCT) technology in the last decade, coronary CT angiography (CTA) has become an increasingly important noninvasive modality in the diagnosis of coronary artery diseases. High temporal and spatial resolution capabilities of MSCT scanners enable detailed 3D visualization of complex coronary artery anatomy without motion artifact.To be able to interpret the coronary CTA correctly, radiologists should be familiar with normal anatomy, anatomic variants, and anomalies of the coronary arteries and their cross-sectional appearances. In this study, we aimed to identify the 64-slice CTA appearance of the anatomic variations and anomalies of the coronary arteries and determine their incidence in a population of 700 patients. Materials and methodsCT data of 700 patients (405 males, 295 females; age range, 17-85 years) who underwent 64-slice coronary CTA in our institution were retrospectively reviewed to identify the coronary anatomy and determine anatomic variants and anomalies. Patients were referred for coronary CTA because of known or suspected coronary artery disease (CAD). The institutional review board approved the study. CT scanAll CT examinations were performed by a 64-slice CT scanner (Aquillon 64, Toshiba Medical Systems, Tochigi, Japan) with retrospective ECG gating (scan protocol is given in Table 1). Patients with a heart rate greater than 75 beats/min were premedicated with an oral dose of 40 mg propronalol one hour before the scan. Sublingual nitroglycerine was delivered to the patient just before the scan. For venous access, an upper extremity vein (antecubital vein of the right arm) and a 20-gauge IV cannula was used. A total of 80-85 mL of contrast media with high iodine concentration (≥350 mg/mL) was injected with a flow rate of 5 mL/s, followed by a 20 mL saline chaser. The scan timing was determined with automated bolus tracking technique by placing the region of interest over the proximal descending aorta and setting the trigger threshold to 180 HU.Raw spiral CT data were reconstructed in various phases of the cardiac cycle to obtain images with the highest quality (without motion artifact). Reconstruction performed at 75% of R-R interval was found to be optimal for image analysis in most patients. Image analysisImages reconstructed at the optimal phase were transferred to another workstation (Vitrea 2 workstation, Vital Images Inc., Plymouth, Minne- CARDIOVASCULAR IMAGING PURPOSETo retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery anatomic variants and anomalies and determine their incidence in 700 patients. MATERIALS AND METHODSCT data of 700 patients who underwent 64-slice CT angiography (CTA) because of known or suspected coronary artery disease were retrospectively reviewed by two radiologists experienced in cardiovascular radiology. In each study, anatomic varia...

The purpose of the study was to assess the presence and extent of atherosclerosis determined by 64-slice CTA in patients with 0 coronary calcium score (CACS) and to evaluate the affect of demographic features and risk factors on the atheroma burden of these patients. 883 cases (378 (42.8%) male, 505 (57.2%) female, mean age 51.28) with zero CACS were included in the study. Cases underwent CTA because of carrying risk factors or having chest pain or atypical symptoms. A non-enhanced CT scan was obtained for calcium scoring immediately before CTA in all cases. CT examinations were performed by 64-slice scanner (Toshiba, Aquillon 64, Toshiba Medical Systems, Otowara, Japan). Coronary artery disease (CAD) was graded according to CTA findings and five groups were defined. In 703 cases (79.6%) CTA was normal while 180 (20.4%) cases had positive CTA findings and 43 cases (4.9%) had CTA obstructive lesion. Cases with positive CTA findings were significantly older than those with normal CTA Diabetes was a significant risk factor of CAD in both male and female cases. Dyslipidemia was associated with CAD in males and family history of CAD was a significant risk factor for females with positive CTA findings. This study demonstrated that considerable amount of patients with zero CAC score have positive CTA findings. Age and diabetes are the risk factors, which were associated with positive CTA findings in both sexes. Dyslipidemia was a significant risk factor in males and family history of CAD in females. Especially in patients with risk factors CTA is better than CAC scoring in determining the atheroma burden.

No abstract

No abstract