Visualization of anomalous coronary arteries on dual-source computed tomography

Abstract

The purpose of this study is to assess the capability of dual-source computed tomography (DSCT) in evaluating coronary artery anomalies. Early detection and evaluation of coronary artery anomalies is essential because of their potential association with myocardial ischemia and sudden death. In 16 patients (12 men, mean age 50 +/- 14 years), anomalous coronary arteries were detected on contrast-enhanced DSCT in a patient cohort of 230 individuals (incidence of 7%). Six different types of anomalies were diagnosed (three fistula, four anomalies of the circumflex artery, four anomalous right coronary arteries, three anomalies of the left coronary artery, one absent left main coronary artery, and one left coronary artery arising from the pulmonary trunk). Of the 16 patients, 10 also underwent conventional coronary angiography (CAG). Retrospective evaluation of the CAGs by an experienced interventional cardiologist resulted in a precise diagnosis in 50% of patients. With DSCT, sufficient image quality and exact visualization of the aberrant anatomy were achieved in all patients. Therefore, DSCT seems to be an accurate diagnostic tool for examining the precise origin, course, and shape of aberrant coronary arteries.

Progressive intra-individual radiation dose reduction during CT surveillance of a patient with alcapa syndrome

“…As demonstrated in our case and confirmed by other studies, the emergence and ongoing refinements of cCTA increasingly enable replacement of invasive testing with non-invasive, comprehensive CT assessment of cardiac morphology and function, which arguably has greater efficacy than coronary catheterization for demonstrating the ostial origin and proximal course of anomalous coronary arteries (2,3,6).…”

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

“…Third, the invasive nature of conventional angiography has a mortality of 0.1%. 16 In our study, coronary CTA helped surgeons with pre-operative planning as well as follow-up studies (Figure 4). DSCT could provide motion-free high-resolution images by using an electrocardiographically gated technique, especially for coronary CTA with complex vascular anatomy, despite the limited haemodynamic information.…”

“…DSCT could provide motion-free high-resolution images by using an electrocardiographically gated technique, especially for coronary CTA with complex vascular anatomy, despite the limited haemodynamic information. The multiplanar reformation can clearly demonstrate the sites of origin and termination of abnormal blood vessels, 16,17 and the volume-rendered images acquired from three-dimensional CT data sets can provide an overview of the heart as well as its vascular anatomy and help surgeons to understand the anatomical complexity before surgery. 8,14,18 Therefore, DSCT could provide more information than conventional coronary angiography for the diagnosis of coexistent abnormalities.…”

Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus: Case report

“…3 Other diagnostic modalities, such as coronary angiography, are of limited value because they provide only two-dimensional pictures and cannulation of the aberrant coronary artery can be difficult. 4 In view of these limitations, cardiac CT is recommended as the imaging modality of choice in diagnosing such anomalies. …”